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Ethnic and geographic differences in mammographic density and their association with breast cancer incidence

Breast Cancer Research and Treatment volume 104, pages 47–56 (2007)Cite this article

Abstract

The objective of this pooled analysis was to compare differences in dense areas and percent mammographic densities to breast cancer incidence in populations at different breast cancer risk. The data set included 1,327 women aged 40–80: Caucasians from Norway, Arizona, and Hawaii, Japanese from Hawaii and Japan, Latina from Arizona, and Native Hawaiians from Hawaii. One reader performed computer-assisted quantitative density assessment for all mammographic films. Multiple linear regression models evaluated the influence of the covariates on breast density. Spearman correlation coefficients (r s) estimated the association between breast density and breast cancer incidence for the seven populations. After adjustment for covariates, ethnicity, but not location, was significantly associated with breast density. In the full model, 19% of the variation in the dense areas and 46% in the variation of percent densities were explained by measured risk factors. Native Hawaiians had the largest dense areas and women in Japan the smallest, whereas percent densities were highest among Native Hawaiians and Japanese in Hawaii and lowest among Norwegian women. The mean age-adjusted dense area had the strongest association with breast cancer incidence (r s = 0.93, P = 0.003); the relation with percent density was considerably weaker (r s = 0.32, P = 0.48). The correlation between age-adjusted dense area and breast cancer incidence remained strong after selectively removing individual data points. This comparison of mammographic densities suggests that, on a group level, age-adjusted dense areas may reflect breast cancer incidence better than percent densities.

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Acknowledgements

This combined project was funded by Grant R03 CA105948 from the National Cancer Institute. The studies in Hawaii were supported by NIH Grants R01 CA80843 and R01 CA 85265 and by an award from the U.S. Army Medical Research Materiel Command under DAMD17-00-1-0281. The data collection in Japan was funded by NIH Grant R03 CA 81620 and by a grant from the Ministry of Education, Science, Sports, and Culture, Japan. The Arizona Study was supported by the Susan G. Koman Breast Cancer Foundation. BCTR 2000 538. The Norwegian part of the study was supported by the Department of Clinical Research; University Hospital of North Norway, the Norwegian Cancer Society, the Aakre Foundation, the Norwegian Women’s Public Health Association (Grant H3-02), the Research Council of Norway (Visiting Scientist Award grant 148365/300), and the University of Tromsø, Norway. We are grateful to Laurence N. Kolonel and Brian E. Henderson for access to the Multiethnic Cohort study, Eiliv Lund for the collaboration with the NOWAC study and the use of the diet questionnaire, Ilene Brill for her programming efforts, and Lynne Wilkens for her statistical advice. Last and most importantly, we want to thank the women participating in the studies.

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Affiliations

  1. Cancer Research Center of Hawaii, 1236 Lauhala Street, Honolulu, HI, 96813, USA

    Gertraud Maskarinec & Ian Pagano

  2. College of Public Health, University of Arizona, Tucson, AZ, USA

    Zhao Chen

  3. School of Medicine, University of Gifu, 1-1 Yanagido, Gifu, 501-1194, Japan

    Chisato Nagata

  4. School of Medicine, University of Tromsø, Tromsø, Norway

    Inger Torhild Gram

Authors
  1. Gertraud Maskarinec
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  2. Ian Pagano
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  3. Zhao Chen
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  4. Chisato Nagata
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  5. Inger Torhild Gram
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Correspondence to Gertraud Maskarinec.

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Maskarinec, G., Pagano, I., Chen, Z. et al. Ethnic and geographic differences in mammographic density and their association with breast cancer incidence. Breast Cancer Res Treat 104, 47–56 (2007). https://doi.org/10.1007/s10549-006-9387-5

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Keywords

  • Breast density
  • Breast cancer incidence
  • Ethnicity
  • Risk factors