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

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

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.

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Data availability

The datasets generated and analysed during the current study are not publically available but can be made available upon request (and pending approval) from Western Australia’s Department of Health Data Linkage Branch and BreastScreen Western Australia.

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

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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.

Author information

Authors and Affiliations

  1. Centre for Genetic Origins of Health and Disease, Curtin University and The University of Western Australia, 35 Stirling Highway, M409, Perth, WA, 6009, Australia

    Ellie Darcey, Rachel Lloyd, Gemma Cadby & Jennifer Stone

  2. BreastScreen Western Australia, Women and Newborn Health Service, 9th Floor, Eastpoint Plaza, 233 Adelaide Terrace, Perth, WA, 6000, Australia

    Leanne Pilkington & Elizabeth Wylie

  3. School of Medicine, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia

    Andrew Redfern, Christobel Saunders & Elizabeth Wylie

  4. Fiona Stanley Hospital, Robin Warren Drive, Murdoch, WA, Australia

    Andrew Redfern & Christobel Saunders

  5. School of Population and Global Health, Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald St, Geraldton, WA, 6531, Australia

    Sandra C Thompson

  6. The RPH Research Foundation, Royal Perth Hospital, 50 Murray Street, Perth, WA, 6000, Australia

    Jennifer Stone

Authors
  1. Ellie Darcey
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  2. Rachel Lloyd
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  3. Gemma Cadby
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  4. Leanne Pilkington
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  5. Andrew Redfern
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  6. Sandra C Thompson
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  7. Christobel Saunders
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  8. Elizabeth Wylie
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  9. Jennifer Stone
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Corresponding author

Correspondence to Jennifer Stone.

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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.

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Darcey, E., Lloyd, R., Cadby, G. et al. The association between mammographic density and breast cancer risk in Western Australian Aboriginal women. Breast Cancer Res Treat 176, 235–242 (2019). https://doi.org/10.1007/s10549-019-05225-9

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  • DOI: https://doi.org/10.1007/s10549-019-05225-9

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