Left–right breast asymmetry and risk of screen-detected and interval cancers in a large population-based screening population

Abstract

Objectives: To assess the associations between automated volumetric estimates of mammographic asymmetry and breast cancers detected at the same (“contemporaneous”) screen, at subsequent screens, or in between (interval cancers). Methods: Automated measurements from mammographic images (N = 79,731) were used to estimate absolute asymmetry in breast volume (BV) and dense volume (DV) in a large ethnically diverse population of attendees of a UK breast screening programme. Logistic regression models were fitted to assess asymmetry associations with the odds of a breast cancer detected at contemporaneous screen (767 cases), adjusted for relevant confounders. Nested case–control investigations were designed to examine associations between asymmetry and the odds of: (a) interval cancer (numbers of cases/age-matched controls: 153/646) and (b) subsequent screen-detected cancer (345/1438), via conditional logistic regression. Results: DV, but not BV, asymmetry was positively associated with the odds of contemporaneous breast cancer (P-for-linear-trend (Pt) = 0.018). This association was stronger for first (prevalent) screens (Pt = 0.012). Both DV and BV asymmetry were positively associated with the odds of an interval cancer diagnosis (Pt = 0.060 and 0.030, respectively). Neither BV nor DV asymmetry were associated with the odds of having a subsequent screen-detected cancer. Conclusions: Increased DV asymmetry was associated with the risk of a breast cancer diagnosis at a contemporaneous screen or as an interval cancer. BV asymmetry was positively associated with the risk of an interval cancer diagnosis. Advances in knowledge: The findings suggest that DV and BV asymmetry may provide additional signals for detecting contemporaneous cancers and assessing the likelihood of interval cancers in population-based screening programmes.

Breast Fluctuating Asymmetry in Women with Macromastia/Gigantomastia

“…Moreover, women with macromastia and/or gigantomastia breasts present higher FA than “normal” breasts. Based on the study by Hudson et al (2020), this observation may give a rationale for earlier and more frequent prophylactic breast imaging in women with macromastia and/or gigantomastia [ 14 ]. Moreover, in the aspect of analysing breast size as a signalling trait, it seems that macromastia and/or gigantomastia may be a signal of low phenotypic quality.…”

“…The rationale for such speculations was based on studies that showed positive correlations between breast size and asymmetry and breast cancer risk. Kusano et al (2006) reported that for lean women, larger breast size was associated with a higher risk of breast cancer, while Hudson et al (2020) presented positive correlations between breast asymmetry and breast cancer diagnosis [14,19]. Scutt et al (1997Scutt et al ( , 2006 considered mammograms of women with breast cancer and compared them with healthy controls.…”

“…Hudson et al (2020) assessed the associations between automated volumetric estimates of mammographic asymmetry and breast cancers. After analysing 79,731 mammographic images, the authors concluded that breast volume asymmetry was positively associated with the risk of an interval cancer diagnosis [ 1 , 14 , 15 , 16 ].…”

Right–left digit ratios, a novel form of asymmetry: Patterns of instability in children and relationships to platelet counts and hospitalization in adults with COVID-19

“…In contrast, asymmetry of paired body traits (FA) has been the subject of much research related to health and fertility. In humans, elevated levels of FA are associated with reduced ejaculate size and poor quality of sperm (2), smaller family size (3,4), high resting metabolic rate (4,5), elevated weight and BMI (6,7), schizophrenia (8), attention deficit disorder (9), developmental delays in childhood (10), Down's syndrome (11) and breast cancer (12)(13)(14)(15). For reviews see Thornhill and Moller (16) and Benderlioglu (17).…”