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Influence of breast density on breast cancer risk: a case control study in Japanese women

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Abstract

Background

Mammography is the standard examination for breast cancer screening of woman aged ≥ 40 years. High breast density on mammography indicates that mammary gland parenchyma occupy a high percentage of the breast. The objective of this study was to investigate factors associated with breast density and the risk of high breast density for breast cancer.

Methods

A multicenter case–control study was performed in 530 patients and 1043 controls. Breast density was classified as C1–C4 using the Breast Imaging Reporting and Data System (BI-RADS). Clinical factors were obtained from questionnaires or medical records, and the influence of each factor (breast density, menopausal status, body mass index (BMI), parity, presence or absence of breastfeeding history, age at menarche, age at first birth, and familial history of breast cancer) on breast cancer risk in all patients was calculated as an age-adjusted odds ratio (OR). Multivariate logistic regression analyses were then performed in all patients and in pre- and postmenopausal and BMI-stratified groups using factors with a significant age-adjusted OR as adjustment factors.

Results

Age-adjusted ORs for breast cancer were significant for breast density, BMI, parity, and breast feeding, but not for age at menarche, age at first birth, or family history of breast cancer. In multivariate analysis, there was a significant correlation between breast density and breast cancer in postmenopausal women (OR for C1 vs. C2 1.90 [95% CI 1.34–2.70]; C1 vs. C4 2.85 [95% CI 1.10–7.16]). This correlation was also significant in patients in the third BMI quartile (22.3–24.5 kg/m2) (OR for C1 vs. C4 8.76 [95% CI 2.38–42.47]); and fourth BMI quartile (>24.5 kg/m2) (OR for C1 vs. C2 1.92 [95% CI 1.17–3.15]; C1 vs. C4 11.89 [95% CI 1.56–245.17]).

Conclusion

Breast density on mammography is a risk factor for breast cancer after adjustment for other risk factors. This risk is particularly high in postmenopausal women and those with a high BMI.

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Acknowledgements

This study was supported by a Grant-in-Aid for Scientific Research, Scientific Research (C) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

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Authors and Affiliations

  1. Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan

    Keiko Nishiyama, Naruto Taira, Taeko Mizoo, Mariko Kochi, Hirokuni Ikeda, Takayuki Iwamoto, Tadahiko Shien, Hiroyoshi Doihara & Shinichi Toyooka

  2. Department of Radiology, Okayama Saiseikai General Hospital, 1-17-18 Ifuku-cho, Kitaku, Okayama, 700-8511, Japan

    Setuko Ishihara

  3. Department of Breast Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidori-machi, Minamiku, Okayama, 702-8055, Japan

    Hiroshi Kawai

  4. Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Nakaku, Hiroshima, 730-8518, Japan

    Kensuke Kawasaki

  5. Department of Breast Surgery, Mizushima Kyodo Hospital, 1-1 Mizushima minamikasuga-cho, Kurashiki, Okayama, 712-8567, Japan

    Yoichi Ishibe

  6. Department of Breast Endocrine Surgery, Kagawa Prefecture Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan

    Yutaka Ogasawara

Authors
  1. Keiko Nishiyama
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  2. Naruto Taira
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  3. Taeko Mizoo
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  4. Mariko Kochi
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  5. Hirokuni Ikeda
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  6. Takayuki Iwamoto
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  7. Tadahiko Shien
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  8. Hiroyoshi Doihara
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  9. Setuko Ishihara
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  10. Hiroshi Kawai
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  11. Kensuke Kawasaki
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  12. Yoichi Ishibe
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  13. Yutaka Ogasawara
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  14. Shinichi Toyooka
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Corresponding author

Correspondence to Naruto Taira.

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The authors declare that they have no conflicts of interest.

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This article does not contain studies on animals.

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All subjects and controls gave written informed consent.

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Cite this article

Nishiyama, K., Taira, N., Mizoo, T. et al. Influence of breast density on breast cancer risk: a case control study in Japanese women. Breast Cancer 27, 277–283 (2020). https://doi.org/10.1007/s12282-019-01018-6

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  • DOI: https://doi.org/10.1007/s12282-019-01018-6

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