Tamoxifen-Induced Reduction in Mammographic Density and Breast Cancer Risk Reduction: A Nested Case-Control Study

Abstract

The 12- to 18-month change in mammographic breast density is an excellent predictor of response to tamoxifen in the preventive setting.

A case‐control study to assess the impact of mammographic density on breast cancer risk in women aged 40–49 at intermediate familial risk

“…After adjusting for absolute nondense area, every additional 10 cm 2 of dense tissue was associated with a 7% increase in odds of breast cancer in all women (n 5 292, actual age range [40][41][42][43][44][45][46][47][48][49][50], but with a 14% increase in premenopausal women (n 5 200, actual age range [40][41][42][43][44][45][46][47][48][49][50]. MD may therefore be an even more important risk factor in premenopausal compared to postmenopausal women among those at higher-thanaverage risk not currently within screening age range.…”

“…15 In addition, women who experienced a tamoxifen-induced breast density reduction of at least 10% were found to have a 63% relative reduction in breast cancer risk. 50 In the future, aromatase inhibitors and gonadotropin-releasing hormone agonists may be used in premenopausal women at increased risk. 51 In summary, absolute density aided discrimination between cases and controls in this population at enhanced familial risk for breast cancer, in particular among premenopausal women.…”

Breast composition: Measurement and clinical use

“…3,[6][7][8] Additionally, there is a genetic predisposition to breast density, 9,10 and other established risk factors for breast cancer such as hormonal agents, 11,12 lifestyle, and reproductive characteristics are associated with high breast density. [13][14][15][16] Importantly, breast density is a potentially modifiable risk factor for breast cancer, 17,18 and lower density has been shown to be a prognostic factor for the effect of interventions on breast cancer risk. 19 Some lifestyle parameters responsible for high breast density and breast cancer are controllable, 20 and consumption of food species such as vegetables, vitamin D, and calcium may have an ameliorative impact on the breast density and breast cancer risk.…”

“…This will allow for shared decision-making between screened women and their physicians concerning strategies to reduce the associated risks and facilitate better decisions regarding screening. 17,19,27 National level breast density information will enable breast cancer risk stratification, 27,28 leading to selection of appropriate imaging pathways such as ultrasound, 29,30 digital breast tomosynthesis (DBT), 31 and magnetic resonance imaging (MRI) 30 to improve cancer detection in the dense breast.…”

“…Data on breast density will enable use of breast density as a marker for monitoring the effect of breast cancer prevention and control interventions. 17,19 The relevance of breast density information in clinical decision-making for screened women underscores the need for methods of breast density assessment to be standardized, reliable, and reproducible, as this will support clinical decisions made from breast density assessment. In this paper we revisit breast morphological and radiographic anatomy.…”