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The association between mammographic density and breast cancer risk in Western Australian Aboriginal women

  • Ellie Darcey
  • Rachel Lloyd
  • Gemma Cadby
  • Leanne Pilkington
  • Andrew Redfern
  • Sandra C Thompson
  • Christobel Saunders
  • Elizabeth Wylie
  • Jennifer StoneEmail author
Epidemiology
  • 48 Downloads

Abstract

Purpose

Mammographic density is an established breast cancer risk factor within many ethnically different populations. The distribution of mammographic density has been shown to be significantly lower in Western Australian Aboriginal women compared to age- and screening location-matched non-Aboriginal women. Whether mammographic density is a predictor of breast cancer risk in Aboriginal women is unknown.

Methods

We measured mammographic density from 103 Aboriginal breast cancer cases and 327 Aboriginal controls, 341 non-Aboriginal cases, and 333 non-Aboriginal controls selected from the BreastScreen Western Australia database using the Cumulus software program. Logistic regression was used to examine the associations of percentage dense area and absolute dense area with breast cancer risk for Aboriginal and non-Aboriginal women separately, adjusting for covariates.

Results

Both percentage density and absolute dense area were strongly predictive of risk in Aboriginal women with odds per adjusted standard deviation (OPERAS) of 1.36 (95% CI 1.09, 1.69) and 1.36 (95% CI 1.08, 1.71), respectively. For non-Aboriginal women, the OPERAS were 1.22 (95% CI 1.03, 1.46) and 1.26 (95% CI 1.05, 1.50), respectively.

Conclusions

Whilst mean mammographic density for Aboriginal women is lower than non-Aboriginal women, density measures are still higher in Aboriginal women with breast cancer compared to Aboriginal women without breast cancer. Thus, mammographic density strongly predicts breast cancer risk in Aboriginal women. Future efforts to predict breast cancer risk using mammographic density or standardize risk-associated mammographic density measures should take into account Aboriginal status when applicable.

Keywords

Breast cancer risk Mammographic breast density Ethnicity Aboriginal women Mammographic screening 

Abbreviations

ARIA

Accessibility/remoteness index of Australia

BMI

Body mass index

CI

Confidence interval

DA

Dense area

FFDM

Full-field digital mammogram

HT

Hormone therapy

MD

Mammographic density

OPERA

Odds per adjusted standard deviation

OR

Odd ratio

PDA

Percent dense area

SD

Standard deviation

SE

Standard error

SEIFA

Socio-economic indexes for areas

SES

Socio-economic status

TA

Total area (of the breast)

WA

Western Australia

Notes

Acknowledgements

The authors would like to acknowledge BreastScreen Western Australia, The Aboriginal Women’s Reference Group and the Government of Western Australia Department of Health Data Linkage Branch.

Funding

This work was supported by Cancer Council Western Australia and Cancer Australia (APP1085750). Author JS is a National Breast Cancer Foundation Research Fellow.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Western Australian Department of Health Human Research Ethics Committee (Project #2014/50) and the Western Australian Aboriginal Health Ethics Committee (Project 581)) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

A waiver of informed consent was received to obtain access to de-identified linked data.

Supplementary material

10549_2019_5225_MOESM1_ESM.doc (101 kb)
Supplementary material 1 (DOC 101 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centre for Genetic Origins of Health and DiseaseCurtin University and The University of Western AustraliaPerthAustralia
  2. 2.BreastScreen Western Australia, Women and Newborn Health ServicePerthAustralia
  3. 3.School of MedicineThe University of Western AustraliaPerthAustralia
  4. 4.Fiona Stanley HospitalMurdochAustralia
  5. 5.School of Population and Global Health, Western Australian Centre for Rural HealthThe University of Western AustraliaGeraldtonAustralia
  6. 6.The RPH Research FoundationRoyal Perth HospitalPerthAustralia

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