Migration History, Language Acculturation, and Mammographic Breast Density

Abstract

Breast cancer incidence is lower in many U.S. ethnic minority and foreign-born population groups. Investigating whether migration and acculturation patterns in risk are reflected in disease biomarkers may help to elucidate the underlying mechanisms. We compared the distribution of breast cancer risk factors across U.S.-born white, African American and Hispanic women, and foreign-born Hispanic women ( = 477, ages 40-64 years, 287 born in Caribbean countries). We used linear regression models to examine the associations of migration history and linguistic acculturation with mammographic breast density (MBD), measured using computer-assisted methods as percent and area of dense breast tissue. The distribution of most breast cancer risk factors varied by ethnicity, nativity, and age at migration. In age- and body mass index-adjusted models, U.S.-born women did not differ in average MBD according to ethnicity, but foreign-born Hispanic women had lower MBD [e.g., -4.50%; 95% confidence interval (CI), -7.12 to -1.89 lower percent density in foreign- vs. U.S.-born Hispanic women]. Lower linguistic acculturation and lower percent of life spent in the United States were also associated with lower MBD [e.g., monolingual Spanish and bilingual vs. monolingual English speakers, respectively, had 5.09% (95% CI, -8.33 to -1.85) and 3.34% (95% CI, -6.57 to -0.12) lower percent density]. Adjusting for risk factors (e.g., childhood body size, parity) attenuated some of these associations. Hispanic women predominantly born in Caribbean countries have lower MBD than U.S.-born women of diverse ethnic backgrounds, including U.S.-born Hispanic women of Caribbean heritage. MBD may provide insight into mechanisms driving geographic and migration variations in breast cancer risk. .

Childhood body size and midlife mammographic breast density in foreign-born and U.S.-born women in New York City

“…While collectively the evidence to date point to an inverse association between childhood body size and MBD in postmenopausal women, less is known about whether childhood body size and MBD associations are seen in premenopausal women, particularly across women that may have had different childhood environments. New evidence suggests nativity and migration patterns in adult MBD consistent with their associations with breast cancer risk (22,23). Differences in the social and physical early life environments of U.S., and foreign-born women may plausibly modify the associations between childhood body size and mammographic density, but this question has not been previously investigated.…”

Influence of Childhood Adversity and Infection on Timing of Menarche in a Multiethnic Sample of Women

“…We used data from the New York Mammographic Density Study, a study of breast cancer screening and prevention in women aged 40 to 64 years, recruited during routine screening mammography visits at a community clinic in New York City [ 53 , 54 ]. Of the 1343 women, who were enrolled and completed a baseline questionnaire between 2012 and 2018, 524 were presented with a follow-up questionnaire module on early life exposures, including childhood adversity and infection, of whom 401 (76.5%) completed the data.…”

Breast Density Awareness and Knowledge in a Mammography Screening Cohort of Predominantly Hispanic Women: Does Breast Density Notification Matter?

“…Women completed an interviewer-administered in-person survey in English or Spanish during their screening mammography appointment. 17,18 For this analysis, we excluded women with a personal history of breast cancer (n=4) as their knowledge and screening experiences may differ from average-risk screening populations, as well as women for whom no prior mammogram report was available (n=142), leaving a final sample of 666 women. This study was approved by the Columbia University Medical Center institutional review board and all women provided written informed consent prior to data collection.…”