Involution of Breast Lobules, Mammographic Breast Density and Prognosis Among Tamoxifen-Treated Estrogen Receptor-Positive Breast Cancer Patients

Mullooly, Maeve; Nyante, Sarah J.; Pfeiffer, Ruth M.; Cora, Renata; Butcher, Donna; Sternberg, Lawrence R.; Bowles, Erin J. Aiello; Fan, Shaoqi; Figueroa, Jonine D.; Weinmann, Sheila; Hoover, Robert N.; Brinton, Louise A.; González, Amy Berrington de; Glass, Andrew G.; Sherman, Mark E.; Gierach, Gretchen L.

doi:10.3390/jcm8111868

Cited by 10 publications

(6 citation statements)

References 32 publications

(51 reference statements)

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“…Decreased TDLU involution related to these clinical features suggests that involution patterns may not only be determinants of breast cancer incidence, but could also be associated with clinical outcomes and survival. Although prior work in ER + breast cancer patients did not identify an association between pre-treatment TDLU involution and breast cancer-specific survival [ 25 ], additional work is warranted to elucidate the relationship between TDLU measures and survival across breast cancer molecular subtypes and racial and ethnic population groups.…”

Section: Discussionmentioning

confidence: 99%

Associations between quantitative measures of TDLU involution and breast tumor molecular subtypes among breast cancer cases in the Black Women’s Health Study: a case–case analysis

et al. 2022

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Background Terminal duct lobular units (TDLUs) are the structures in the breast that give rise to most breast cancers. Previous work has shown that TDLU involution is inversely associated with TDLU metrics, such as TDLU count/100mm2, TDLU span (µm), and number of acini/TDLU, and that these metrics may be elevated in the normal breast tissue of women diagnosed with triple-negative (TN) compared with luminal A breast tumors. It is unknown whether this relationship exists in Black women, who have the highest incidence of TN breast cancer and the highest overall breast cancer mortality rate. We examined relationships between TDLU metrics and breast cancer molecular subtype among breast cancer cases in the Black Women’s Health Study (BWHS). Methods We assessed quantitative TDLU metrics (TDLU count/100mm2, TDLU span (µm), and number of acini/TDLU) in digitized 247 hematoxylin and eosin-stained adjacent normal tissue sections from 223 BWHS breast cancer cases, including 65 triple negative (TN) cancers (estrogen receptor (ER) negative, progesterone receptor (PR) negative, human epidermal growth factor-2 (HER2) negative) and 158 luminal A cancers (ER positive, HER2 negative). We evaluated associations of least square mean TDLU metrics adjusted for age and body mass index (BMI) with patient and clinical characteristics. In logistic regression models, we evaluated associations between TDLU metrics and breast cancer subtype, adjusting for age, BMI, and tumor size. Results Older age and higher BMI were associated with lower TDLU metrics and larger tumor size and lymph node invasion with higher TDLU metrics. The odds of TN compared with luminal A breast cancer increased with increasing tertiles of TDLU metrics, with odds ratios (95% confidence intervals) for tertile 3 versus tertile 1 of 2.18 (0.99, 4.79), 2.77 (1.07, 7.16), and 1.77 (0.79, 3.98) for TDLU count, TDLU span, and acini count/TDLU, respectively. Conclusion Associations of TDLU metrics with breast cancer subtypes in the BWHS are consistent with previous studies of White and Asian women, demonstrating reduced TDLU involution in TN compared with luminal A breast cancers. Further investigation is needed to understand the factors that influence TDLU involution and the mechanisms that mediate TDLU involution and breast cancer subtype.

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Section: Discussionmentioning

confidence: 99%

Associations between quantitative measures of TDLU involution and breast tumor molecular subtypes among breast cancer cases in the Black Women’s Health Study: a case–case analysis

et al. 2022

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“…In fact, even a single year of treatment with estrogen plus progestin HRT was sufficient to increase MD as well as breast cancer risk [176]. In contrast, the selective estrogen receptor (ER) modulator tamoxifen [177][178][179][180] and stopping the use of HRT [169,171,181] decreased breast density and/ or the risk of breast cancer. Tamoxifen is an ER antagonist in the breast, and it is sometimes prescribed to reduce risk among women with higher risk of breast cancer, including in women with dense breasts, and it is a first-line treatment to prevent breast cancer recurrence [180,182].…”

Section: Epidemiological Studiesmentioning

confidence: 99%

“…In contrast, the selective estrogen receptor (ER) modulator tamoxifen [177][178][179][180] and stopping the use of HRT [169,171,181] decreased breast density and/ or the risk of breast cancer. Tamoxifen is an ER antagonist in the breast, and it is sometimes prescribed to reduce risk among women with higher risk of breast cancer, including in women with dense breasts, and it is a first-line treatment to prevent breast cancer recurrence [180,182]. These associations provide compelling evidence for the importance of estrogen and progesterone in breast density and cancer [183].…”

Section: Epidemiological Studiesmentioning

confidence: 99%

Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities

Kay

Cardona²,

Rudel³

et al. 2022

Curr Envir Health Rpt

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Population studies show worrisome trends towards earlier breast development, difficulty in breastfeeding, and increasing rates of breast cancer in young women. Multiple epidemiological studies have linked these outcomes with chemical exposures, and experimental studies have shown that many of these chemicals generate similar effects in rodents, often by disrupting hormonal regulation. These endocrine-disrupting chemicals (EDCs) can alter the progression of mammary gland (MG) development, impair the ability to nourish offspring via lactation, increase mammary tissue density, and increase the propensity to develop cancer. However, current toxicological approaches to measuring the effects of chemical exposures on the MG are often inadequate to detect these effects, impairing our ability to identify exposures harmful to the breast and limiting opportunities for prevention. This paper describes key adverse outcomes for the MG, including impaired lactation, altered pubertal development, altered morphology (such as increased mammographic density), and cancer. It also summarizes evidence from humans and rodent models for exposures associated with these effects. We also review current toxicological practices for evaluating MG effects, highlight limitations of current methods, summarize debates related to how effects are interpreted in risk assessment, and make recommendations to strengthen assessment approaches. Increasing the rigor of MG assessment would improve our ability to identify chemicals of concern, regulate those chemicals based on their effects, and prevent exposures and associated adverse health effects.

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“…Physiological changes in the breast and restriction in the examination of pregnant patients delay the diagnosis, and staging should be determined as soon as the disease is diagnosed in pregnant women and treatment should be chosen by considering the stage of the disease and minimizing the risks to the fetus (18,28). (36)(37)(38).…”

Section: Epidemiologymentioning

confidence: 99%

Breast Cancer and Ways to Diagnose the Risk Factors and Treat it During Pregnancy: A Narrative Review

Ghamari¹,

Ghaderi²,

Moghaddam³

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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IntroductionBreast cancer is a type of cancer that starts in the breast tissue and can spread to other nearby tissues in addition to affecting the entire breast tissue (1). It is the most common cancer worldwide, causing extensive mortality and many complications (2-4). The incidence of breast cancer is globally increasing, especially in developing countries. Notably, about 6 million women with breast cancer were globally identified during 2008-2013 (5). More than 255 000 new cases of breast cancer occurred in the United States in 2017. Meanwhile, the annual incidence of breast cancer is 33 cases per 100 000 people in Iran, and the highest rate has occurred in Tehran, Isfahan, Yazd, Markazi, and Fars provinces (6).One of the concerns associated with breast cancer is its experience during pregnancy (7). Pregnancy-associated breast cancer refers to cancer that occurs during pregnancy, breastfeeding, or one year after delivery. It is the second most common cancer in pregnancy, which rarely occurs and does not cause many deaths (8,9). Diagnostic and therapeutic interventions during this period are implemented with special considerations. Women with breast cancer are clearly at a more advanced stage of the disease during pregnancy and usually have a poorer prognosis (10,11). One of the major challenges in diagnosis and treatment during this period is maintaining a balance in the aggressive care of these patients and appropriate treatments to maintain the health of the fetus/ baby. Given that the occurrence of this cancer during pregnancy can have adverse effects on the health of the mother, the baby, and the fetus, the current study aimed to investigate the factors affecting the incidence of this type of cancer during pregnancy. Materials and MethodsThis review study aimed at evaluating the relationship between pregnancy-related variables and the risk of breast cancer. This article review focused on all studies performed in this field until 2019. The related studies were selected from Persian and English databases. Iranian databases included SID, Irandoc, and Magiran, and English databases included PubMed, Scopus, Science Direct, Cochrane, Google Scholar, and Embase. Keywords were based on Mesh, including breast cancer and pregnancy. The inclusion criterion was accessing the full text of the articles, and the exclusion criterion was conference papers and articles, full-text versions of which were unavailable. ResultsIn general, 161 articles were found in the first stage although they were excluded from the review process at different stages and for scientific reasons. Finally, 83

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Involution of Breast Lobules, Mammographic Breast Density and Prognosis Among Tamoxifen-Treated Estrogen Receptor-Positive Breast Cancer Patients

Cited by 10 publications

References 32 publications

Associations between quantitative measures of TDLU involution and breast tumor molecular subtypes among breast cancer cases in the Black Women’s Health Study: a case–case analysis

Associations between quantitative measures of TDLU involution and breast tumor molecular subtypes among breast cancer cases in the Black Women’s Health Study: a case–case analysis

Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities

Breast Cancer and Ways to Diagnose the Risk Factors and Treat it During Pregnancy: A Narrative Review

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