Cancer Causes & Control

, Volume 22, Issue 4, pp 599–610

Reproductive and menstrual factors and mammographic density in African American, Caribbean, and white women

  • Parisa Tehranifar
  • Diane Reynolds
  • Julie Flom
  • Loralee Fulton
  • Yuyan Liao
  • Elizabeth Kudadjie-Gyamfi
  • Mary Beth Terry
Original paper



We investigated the associations between reproductive and menstrual risk factors for breast cancer and mammographic density, a strong risk factor for breast cancer, in a predominantly ethnic minority and immigrant sample.


We interviewed women (42% African American, 22% African Caribbean, 22% White, 9% Hispanic Caribbean, 5% other) without a history of breast cancer during their mammography appointment (n = 191, mean age = 50). We used a computer-assisted method to measure the area and percentage of dense breast tissue from cranio-caudal mammograms. We used multivariable linear regression analyses to estimate the associations between reproductive and menstrual risk factors and mammographic density.


Age was inversely associated with percent density and dense area, and body mass index (BMI) was inversely associated with percent density. Adjusting for age, BMI, ethnicity and menopausal status, later age at menarche (e.g., β = −7.37, 95% CI: −12.29, −2.46 for age ≥13 years vs. ≤11 years), and any use of hormonal birth control (HBC) methods (β = −5.10, 95% CI: −9.37, −0.84) were associated with reduced dense area. Ethnicity and nativity (foreign- vs. US-born) were not directly associated with density despite variations in the distribution of several risk factors across ethnic and nativity groups.


The mean level of mammographic density did not differ across ethnic and nativity groups, but several risk factors for breast cancer were associated with density in ethnic minority and immigrant women.


Breast cancer Mammographic density Risk factors Ethnicity Nativity status 


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Parisa Tehranifar
    • 1
    • 2
  • Diane Reynolds
    • 3
  • Julie Flom
    • 1
  • Loralee Fulton
    • 5
  • Yuyan Liao
    • 1
  • Elizabeth Kudadjie-Gyamfi
    • 4
  • Mary Beth Terry
    • 1
    • 2
  1. 1.Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkUSA
  2. 2.Herbert Irving Comprehensive Cancer CenterColumbia University Medical CenterNew YorkUSA
  3. 3.School of NursingLong Island UniversityBrooklynUSA
  4. 4.Department of PsychologyLong Island UniversityBrooklynUSA
  5. 5.Othmer Cancer CenterLong Island College HospitalBrooklynUSA

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