The metabolic syndrome and mammographic breast density in a racially diverse and predominantly immigrant sample of women

Tehranifar, Parisa; Protacio, Angeline; Schmitt, Karen M.; Desperito, Elise; Oskar, Sabine; Potter, Alan; Engmann, Natalie J.; Terry, Mary Beth

doi:10.1007/s10552-015-0630-4

Cited by 15 publications

(26 citation statements)

References 62 publications

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“…Participants were drawn from a sample of women who were enrolled into an ongoing observational study from a large screening mammography clinic in New York City. Of this study sample, 41 women met the eligibility criteria of self‐identifying as Hispanic and having a history of dense breasts since the enactment of NYS notification legislation, defined according to the BDN legislation (BI‐RADS density categories c and d) . Participant characteristics and risk factors were assessed at the time of enrollment (2012‐2014), which occurred on average 2.5 years prior to the qualitative interviews in the current study.…”

Section: Methodsmentioning

confidence: 99%

“…Of this study sample, 41 women met the eligibility criteria of self-identifying as Hispanic and having a history of dense breasts since the enactment of NYS notification legislation, defined according to the BDN legislation (BI-RADS density categories c and d). 11,12 Participant characteristics and risk factors were assessed at the time of enrollment (2012-2014), which occurred on average 2.5 years prior to the qualitative interviews in the current study. All participants were sent BDN as part of their clinical mammography report in English and Spanish, but none had received any information regarding breast health or breast density as part of their participation in the study.…”

Section: Study Setting and Proceduresmentioning

confidence: 99%

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“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

Pacsi‐Sepulveda

Shelton

Rodríguez

et al. 2019

Cancer

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Background Patient advocacy has led to state‐level legislative mandates for the release of personal mammographic breast density information to women undergoing screening mammography. More research is needed to understand the impact of this information on women’s perceptions and mammography screening behavior. Methods Semistructured interviews were conducted in English and Spanish with 24 self‐identified Hispanic women who had undergone at least 1 mammogram since breast density notification was enacted in New York State. The women ranged in age from 43 to 63 years. Women were asked about their understanding and perceptions of the communication of New York State‐mandated breast density information, and any actions they have taken or would take in response to this information. A content analysis of the qualitative data from the translated and transcribed interviews was conducted. Results The majority of participants had no prior knowledge of breast density and expressed confusion and apprehension regarding the meaning of dense breasts when presented with the notification information. Many participants understood having dense breasts to be a serious and abnormal condition, and reported feelings of worry and vulnerability. Participants mostly expressed a strong interest in learning about breast density and obtaining additional and more frequent breast cancer screening tests. These behavioral intentions were consistent with participants’ overall favorable view of breast cancer screening and a belief that their faith, as well as regular screening, can help to protect them from breast cancer morbidity and mortality. Conclusions Hispanic women conveyed proactive breast cancer screening intentions in response to breast density notification, despite inadequate comprehension of this information and negative emotional responses.

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Section: Methodsmentioning

confidence: 99%

Section: Study Setting and Proceduresmentioning

confidence: 99%

“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

Pacsi‐Sepulveda

Shelton

Rodríguez

et al. 2019

Cancer

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“…Though prior studies on statin use and MBD are limited and mixed, high blood cholesterol diagnoses (agnostic of medication use) have been inversely associated with percent density and dense area [42]. Furthermore, low blood high-density lipoprotein has been associated with greater dense area [32,43] or percent density [44,45], with some exceptions [46]. Together, these findings lend support for the hypothesis that disruption in the biological pathway involving cholesterol synthesis affected both by statin use and by the underlying disease process leading to statin prescription may be associated with MBD.…”

Section: Discussionmentioning

confidence: 99%

“…We evaluated the association between medication use and MBD in the New York Mammographic Density (NY MaDe) study, an ongoing screening cohort of women, ages 40-60 years at recruitment from mammography screening appointments at a New York City facility from 2016 through 2018. This cohort has been observed to have a high prevalence of cardiometabolic risk factors [26,32]. The response rate was approximately 42%; however, the enrolled sample is socio-demographically representative of the community served by the clinic.…”

Section: Methodsmentioning

confidence: 99%

Independent and joint cross-sectional associations of statin and metformin use with mammographic breast density

et al. 2020

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Background Well-tolerated and commonly used medications are increasingly assessed for reducing breast cancer risk. These include metformin and statins, both linked to reduced hormone availability and cell proliferation or growth and sometimes prescribed concurrently. We investigated independent and joint associations of these medications with mammographic breast density (MBD), a useful biomarker for the effect of chemopreventive agents on breast cancer risk. Methods Using data from a cross-sectional study of 770 women (78% Hispanic, aged 40–61 years, in a mammography cohort with high cardiometabolic burden), we examined the association of self-reported “ever” use of statins and metformin with MBD measured via clinical Breast Imaging Reporting and Data System (BI-RADS) density classifications (relative risk regression) and continuous semi-automated percent and size of dense area (Cumulus) (linear regression), adjusted for age, body mass index, education, race, menopausal status, age at first birth, and insulin use. Results We observed high statin (27%), metformin (13%), and combination (9%) use, and most participants were overweight/obese (83%) and parous (87%). Statin use was associated with a lower likelihood of high density BI-RADS (RR = 0.60, 95% CI = 0.45 to 0.80), percent dense area (PD) (β = − 6.56, 95% CI = − 9.05 to − 4.06), and dense area (DA) (β = − 9.05, 95% CI = − 14.89 to − 3.22). Metformin use was associated with lower PD and higher non-dense area (NDA), but associations were attenuated by co-medication with statins. Compared to non-use of either medication, statin use alone or with metformin were associated with lower PD and DA (e.g., β = − 6.86, 95% CI: − 9.67, − 4.05 and β = − 7.07, 95% CI: − 10.97, − 3.17, respectively, for PD) and higher NDA (β = 25.05, 95% CI: 14.06, 36.03; β = 29.76, 95% CI: 14.55, 44.96, respectively). Conclusions Statin use was consistently associated with lower MBD, measured both through clinical radiologist assessment and continuous relative and absolute measures, including dense area. Metformin use was associated with lower PD and higher NDA, but this may be driven by co-medication with statins. These results support that statins may lower MBD but need confirmation with prospective and clinical data to distinguish the results of medication use from that of disease.

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“…We used data from the Image Study, an ongoing study of mammographic density and breast cancer risk in a sample of 400 women, aged 40–64 years, who were recruited during screening mammography appointments in Northern Manhattan in New York City in 2012–2014 (Tehranifar et al, 2015). Sixty-seven percent (n=268) of Image Study participants identified as Hispanic and were included in this analysis.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

April-Sanders

Oskar

Shelton

et al. 2017

Women's Health Issues

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Objective Worry about developing breast cancer (BC worry) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. Methods We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry) or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for breast cancer (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and binary logistic regression. Results In multivariable models, women who perceived higher absolute breast cancer risk (OR=1.66, 95% CI: 1.28, 2.14 for one unit increase in perceived lifetime risk) and comparative breast cancer risk (e.g., OR=2.37, 95% CI: 1.23, 6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. Conclusions In Hispanic women undergoing screening mammography, higher perceptions of breast cancer risk, on both absolute and comparative terms, were independently associated with high BC worry, and were stronger predictors of BC worry than indicators of objective breast cancer risk, including family history, mammographic density and personal breast cancer risk estimates.

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The metabolic syndrome and mammographic breast density in a racially diverse and predominantly immigrant sample of women

Cited by 15 publications

References 62 publications

“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

“You probably can’t feel as safe as normal women”: Hispanic women’s reactions to breast density notification

Independent and joint cross-sectional associations of statin and metformin use with mammographic breast density

Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population

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