Endogenous Sex Hormones and Breast Density in Young Women

Abstract

Background Breast density is a strong risk factor for breast cancer and reflects epithelial and stromal content. Breast tissue is particularly sensitive to hormonal stimuli before it fully differentiates following the first full-term pregnancy. Few studies have examined associations between sex hormones and breast density among young women. Methods We conducted cross-sectional study among 180 women aged 25-29 years old who participated in the Dietary Intervention Study in Children 2006 Follow-up Study. Eighty-five percent of participants attended a clinic visit during their luteal phase of menstrual cycle. Magnetic resonance imaging measured the percentage of dense breast volume (%DBV), absolute dense breast volume (ADBV), and absolute nondense breast volume (ANDBV). Multiple-linear mixed-effect regression models were used to evaluate the association of sex hormones and sex hormone-binding globulin (SHBG) with %DBV, ADBV, and ANDBV. Results Testosterone was significantly positively associated with %DBV and ADBV. The multivariable geometric mean of %DBV and ADBV across testosterone quartiles increased from 16.5% to 20.3% and from 68.6cm3 to 82.3cm3, respectively (Ptrend ≤ 0.03). There was no association of %DBV or ADBV with estrogens, progesterone, non-SHBG bound testosterone or SHBG (Ptrend ≥ 0.27). Neither sex hormones nor SHBG was associated with ANDBV except progesterone; however, the progesterone result was nonsignificant in analysis restricted to women in the luteal phase. Conclusions These findings suggest a modest positive association between testosterone and breast density in young women. Impact Hormonal influences at critical periods may contribute to morphological differences in the breast associated with breast cancer risk later in life.

Factors associated with breast cancer occurrence before the age of 40 in Yaoundé

“…Similar results have been found by Duffy et al 22 The estrogens levels in women with dense breast may not be involved in the occurrence of breast cancer. 23 Carcinogenesis would certainly be related to higher cell volume than in women with less dense breasts. Thus the American College of Radiology recommend supplementary screening tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on individual risk factors in patients with dense breast.…”

Circulating Hormones and Mammographic Density in Premenopausal Women

“…Walker et al also reported a suggestive positive association between SHBG and percent MD in 494 premenopausal women [13]. In contrast, among 180 women aged 25–29, Jung et al found a positive association between testosterone and percent breast density, but no association with SHBG or non-SHBG bound testosterone [14]. The role of SHBG in the body is one of transport and it binds both androgens and estrogens; however, SHBG has a higher affinity for testosterone [44] than estradiol and SHBG concentrations are negatively correlated with testosterone levels but positively correlated with estradiol levels in premenopausal women [38, 45].…”

Quantitative Measurements of Breast Density Using Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis

“…Forty-one studies did not meet the selection inclusion criteria: no adequate breast density data (n = 20), qualitative analysis (n = 12), editorials (n = 4), conference abstracts (n = 3), post-mortem study (n = 1), and phantom study (n = 1). Finally, 38 studies attained the inclusion criteria [1,2,3,5,11,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57] and were included in the analysis as shown in Table 1.…”

“…Several MRI sequences were used to enable the precise differentiation between adipose and fibroglandular tissues; of these, non-contrast-enhanced T1-weighted was widely used either with 2D spin echo or 3D gradient echo. In fact, 16 studies (41.03%) used non-contrast-enhanced T1-weighted [1,2,26,27,28,29,31,33,35,44,45,48,49,50,51,53], while in 12 studies (30.77%) non-contrast-enhanced images were integrated with contrast-enhanced images [25,36,37,38,39,40,41,42,43,44,47,49]. In terms of breast density segmentation/measurement, the majority of the studies (20 studies; 51.28%) used FCM clustering algorithm [1,2,11,25,26,27,28,29,31,32,33,34,35,36,37,38,39,40,41,42], while 7 studies (17.95%) used FCM and N3 algorithm [45,46,47,48,49,50,51], 4 studies (10.26%) interactive thresholding algorithm [3,5,52,53], 4 studies (10.26%) in-house customized software [29,53,54,55], one study (2.56%) manual software […”

“…Among the thirty-eight studies included in the systematic review and meta-analysis, 21 studies qualified for meta-analysis since they reported the percent breast density using an identical expression of measurement and dispersion [1,3,11,25,26,27,28,29,30,31,32,36,37,38,45,48,49,50,53,54,55] (Table 2). However, for the remaining 17 studies, the percent breast density was reported in different format: in eight of these studies, it was defined as a median and interquartile range (IQR) [2,39,40,41,42,43,44,47], and in the other nine, it was reported either in different measurement unit or the subject’s sets were not independent, due to multiple usage [5,33,34,35,46,51,52,56,57]. To perform the meta-analysis precisely, all the measured quantities should be reported in an identical expression of measurement and dispersion, thus we decided to exclude them from the meta-analysis.…”