Mammographic Breast Density and Subsequent Risk of Breast Cancer in Postmenopausal Women According to Tumor Characteristics

open here please ►Mammographic Breast Density and Subsequent Risk of Breast Cancer in Postmenopausal Women According to Tumor Characteristics: "Mammographic Breast Density and Subsequent Risk of Breast Cancer in Postmenopausal Women According to Tumor Characteristics

1. Lusine Yaghjyan,
2. Graham A. Colditz,
3. Laura C. Collins,
4. Stuart J. Schnitt,
5. Bernard Rosner,
6. Celine Vachon and
7. Rulla M. Tamimi

+ Author Affiliations

1. Affiliations of authors: Department of Surgery, Division of Public Health Sciences, Washington University in St Louis School of Medicine, St Louis, MO (LY, GAC); Division of Epidemiology, Department of Health Sciences Research, Institute for Public Health, Washington University in St Louis, St Louis, MO (GAC); Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (LCC, SJS); Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (BR, RMT); Mayo Clinic, Rochester, MN (CV)

1. Correspondence to:
Rulla M. Tamimi, ScD, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115 (e-mail: nhrmt@channing.harvard.edu).

* Received December 16, 2010.
* Revision received May 19, 2011.
* Accepted May 23, 2011.

Abstract

Background Few studies that investigated the associations between breast density and subsequent breast cancer according to tumor characteristics have produced inconclusive findings. We aimed to determine whether the associations between breast density and subsequent breast cancer varied by tumor characteristics.

Methods We included 1042 postmenopausal women diagnosed with breast cancer between June 1, 1989, and June 30, 2004, and 1794 matched control subjects from the Nurses’ Health Study, an ongoing prospective cohort study of 121 701 registered female nurses across the United States. Breast density was estimated from digitized images using computerized techniques. Information on breast cancer risk factors was obtained prospectively from biennial questionnaires before the date of cancer diagnosis for case subjects and matched control subjects. Polychotomous logistic regression was used to assess associations of breast density with tumor subtypes based on invasiveness, histology, size, grade, receptor status, and involvement of lymph nodes. All tests of statistical significance were two-sided.

Results The risk of breast cancer increased progressively with increase in percent breast density (Ptrend < .001). Women with higher breast density (≥50%) showed a 3.39-fold (odds ratio = 3.39, 95% confidence interval = 2.46 to 4.68) increased risk of breast cancer compared with women with lower breast density (<10%). The associations between breast density and breast cancer risk were stronger for in situ compared with invasive tumors (Pheterogeneity < .01), high-grade compared with low-grade tumors (Pheterogeneity = .02), larger (>2 cm) compared with smaller (≤2 cm) tumors (Pheterogeneity < .01), and estrogen receptor–negative compared with estrogen receptor–positive tumors (Pheterogeneity = .04). There were no differences in associations by tumor histology, involvement of lymph nodes, and progesterone receptor and HER2 status (Pheterogeneity > .05).

Conclusions The findings suggest that higher mammographic density is associated with more aggressive tumor characteristics and also with in situ tumors.

* © The Author 2011. Published by Oxford University Press.

- Enviado mediante la barra Google"







Actualidad Ultimas noticias - JANOes - Asocian la densidad de los senos con un mayor riesgo de contraer tumores grandes de alto grado - JANO.es - ELSEVIER: "GINECOLOGÍA
Asocian la densidad de los senos con un mayor riesgo de contraer tumores grandes de alto grado

JANO.es · 01 Agosto 2011 00:23

Diversos estudios sugieren que las mujeres con mayor cantidad de tejido epitelial y estromal presentan más probabilidades de desarrollar cáncer.

Una mayor densidad de los senos se asocia con un mayor riesgo de cáncer de mama y ciertos rasgos de los tumores agresivos, según señala una nueva investigación que publica la revista “Journal of the National Cancer Institute”.

En el estudio, los investigadores usaron mamografías para comparar la densidad de los pechos de 1.042 mujeres posmenopáusicas con cáncer de mama y un grupo de control de 1.794 mujeres posmenopáusicas sin cáncer.

En las mamografías, la densidad de los senos se determina según las proporciones de grasa, tejido conectivo y tejido epitelial de la mama. Investigaciones anteriores habían mostrado que las mujeres con mayores cantidades de tejido epitelial y estromal tienen una mayor densidad y un riesgo más alto de cáncer de mama, pero no se había aclarado si la densidad de los senos era una característica tumoral específica.

Este nuevo estudio mostró que el riesgo de cáncer de mama aumentaba progresivamente con una densidad creciente de los senos. Los investigadores también hallaron que la relación entre la densidad y el cáncer de mama fue más estrecha en los tumores grandes, de alto grado, y receptores de estrógeno negativos que en los pequeños, de bajo grado y receptores de estrógeno positivos.

No hubo asociación entre la densidad de los senos y otros marcadores de agresividad del tumor, como la implicación nodular y el estatus de HER2, señalaron los autores.

'Nuestros resultados sugieren que la densidad de los senos influye sobre el riesgo de subtipos de cáncer de mama mediante mecanismos potencialmente distintos', explicó el equipo del Dr. Rulla M. Tamimi, del Brigham and Women’s Hospital y Harvard Medical School (Estados Unidos).

'Se necesitan más estudios para explicar los procesos biológicos subyacentes y aclarar las posibles vías que llevan de una alta densidad de los senos a los subtipos específicos de carcinoma del seno', añadieron los autores.


Journal of the National Cancer Institute 2011;doi: 10.1093/jnci/djr225
Mammographic Breast Density and Subsequent Risk of Breast Cancer in Postmenopausal Women According to Tumor Characteristics: "- Enviado mediante la barra Google"

Harvard Medical School
Harvard Medical School: "- Enviado mediante la barra Google"

- Enviado mediante la barra Google"