Factors associated with mammographic breast density among women in Karachi Pakistan

Abstract

Background There are no studies done to evaluate the distribution of mammographic breast density and factors associated with it among Pakistani women. Methods Participants included 477 women, who had received either diagnostic or screening mammography at two hospitals in Karachi Pakistan. Mammographic breast density was assessed using the Breast Imaging Reporting and Data System. In person interviews were conducted using a detailed questionnaire, to assess risk factors of interest, and venous blood was collected to measure serum vitamin D level at the end of the interview. To determine the association of potential factors with mammographic breast density, multivariable polytomous logistic regression was used. Results High-density mammographic breast density (heterogeneously and dense categories) was high and found in 62.4% of women. There was a significant association of both heterogeneously dense and dense breasts with women of a younger age group < 45 years (OR 2.68, 95% CI 1.60–4.49) and (OR 4.83, 95% CI 2.54–9.16) respectively. Women with heterogeneously dense and dense breasts versus fatty and fibroglandular breasts had a higher history of benign breast disease (OR 1.90, 95% CI 1.14–3.17) and (OR 3.61, 95% CI 1.90–6.86) respectively. There was an inverse relationship between breast density and body mass index. Women with dense breasts and heterogeneously dense breasts had lower body mass index (OR 0.94 95% CI 0.90–0.99) and (OR 0.81, 95% CI 0.76–0.87) respectively. There was no association of mammographic breast density with serum vitamin D levels, diet, and breast cancer. Conclusions The findings of a positive association of higher mammographic density with younger age and benign breast disease and a negative association between body mass index and breast density are important findings that need to be considered in developing screening guidelines for the Pakistani population.

Global epidemiology of breast cancer based on risk factors: a systematic review

“…Risk factors identified include a family history of breast cancer, early menarche, late menopause, positive family history, and obesity ( 25 ). Viral infections, genetic mutations, lack of knowledge about breast cancer symptoms and risk factors, and low vitamin D levels are also associated with an increased risk of breast cancer ( 26 – 32 ). The prevalence of BRCA1/2 mutations is higher in Indian breast and/or ovarian cancer patients, and delays in the diagnosis and treatment of breast cancer are associated with poor referral systems ( 33 ).…”

“…Age, weight, and breast density are highly correlated with the incidence of BC ( 80 ). According to a study in Pakistani Asian women, younger females are more affected by BC and its prevalence increased from 70% to 130% among females aged 30 to 34 years and among the age group 50-64 years, the percentage prevalence increased from 23.1% to 60.7% ( 26 ) ( Table 1 ). Particularly, the incidence of metastatic BC and high-grade BC in young females has escalated in the past few years.…”

The Level of Awareness Among Healthcare Practitioners Regarding the Relationship Between Breast Density and Breast Cancer

“…The study revealed that most of the participants were not aware that BD decreases with age, increases with childbearing, and also has no relation with breast size. Studies done in different regions observed a significant association of BD with age in which BD decreases as women age especially those in the menopausal stage [17][18][19]. In relation to childbearing, the study of Yaghjyan et al found a positive relation between childbearing in terms of breastfeeding and BD of premenopausal women [20].…”

Associations between breast cancer risk factors and mammographic breast density in a large cross-section of Korean women

“…Increased breast density is related to hormone replacement therapy (HRT) use after menopause, high alcohol consumption, a family history of breast cancer within first-degree relatives, a history of benign breast disease, older age at first birth, nulliparity, higher height and older age at menopause (Kerlikowske et al ., 2010; Dorgan et al ., 2012; Alexeeff et al ., 2019; Azam et al ., 2019; Shamsi et al ., 2021; Han et al ., 2022). In contrast, increased age, higher BMI, ever-smoked, younger age at menarche and oral contraceptive use showed an inverse association with breast density (Checka et al ., 2012; Azam et al ., 2019; Moore et al ., 2020; Shamsi et al ., 2021), suggesting an opposite association with breast cancer. However, most studies on the determining factors for breast density were conducted in Western populations, and studies in Asian populations were limited to a small number of study participants (Sung et al ., 2018; Hanis et al ., 2022).…”