Breast Cancer Research and Treatment

, Volume 161, Issue 2, pp 353–362 | Cite as

Differences in mammographic density between Asian and Caucasian populations: a comparative analysis

  • Nadia Rajaram
  • Shivaani Mariapun
  • Mikael Eriksson
  • Jose Tapia
  • Pui Yoke Kwan
  • Weang Kee Ho
  • Faizah Harun
  • Kartini Rahmat
  • Kamila Czene
  • Nur Aishah Mohd Taib
  • Per Hall
  • Soo Hwang Teo
Epidemiology

Abstract

Purpose

Mammographic density is a measurable and modifiable biomarker that is strongly and independently associated with breast cancer risk. Paradoxically, although Asian women have lower risk of breast cancer, studies of minority Asian women in predominantly Caucasian populations have found that Asian women have higher percent density. In this cross-sectional study, we compared the distribution of mammographic density for a matched cohort of Asian women from Malaysia and Caucasian women from Sweden, and determined if variations in mammographic density could be attributed to population differences in breast cancer risk factors.

Methods

Volumetric mammographic density was compared for 1501 Malaysian and 4501 Swedish healthy women, matched on age and body mass index. We used multivariable log-linear regression to determine the risk factors associated with mammographic density and mediation analysis to identify factors that account for differences in mammographic density between the two cohorts.

Results

Compared to Caucasian women, percent density was 2.0% higher among Asian women (p < 0.001), and dense volume was 5.7 cm3 higher among pre-menopausal Asian women (p < 0.001). Dense volume was 3.0 cm3 lower among post-menopausal Asian women (p = 0.009) compared to post-menopausal Caucasian women, and this difference was attributed to population differences in height, weight, and parity (p < 0.001).

Conclusions

Our analysis suggests that among post-menopausal women, population differences in mammographic density and risk to breast cancer may be accounted for by height, weight, and parity. Given that pre-menopausal Asian and Caucasian women have similar population risk to breast cancer but different dense volume, development of more appropriate biomarkers of risk in pre-menopausal women is required.

Keywords

Mammographic density Breast cancer Asian Caucasian Risk 

Supplementary material

10549_2016_4054_MOESM1_ESM.docx (21 kb)
Supplementary material 1 (DOCX 20 kb)

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Nadia Rajaram
    • 1
    • 2
  • Shivaani Mariapun
    • 1
  • Mikael Eriksson
    • 3
  • Jose Tapia
    • 3
  • Pui Yoke Kwan
    • 1
  • Weang Kee Ho
    • 2
  • Faizah Harun
    • 4
  • Kartini Rahmat
    • 4
    • 5
  • Kamila Czene
    • 3
  • Nur Aishah Mohd Taib
    • 4
  • Per Hall
    • 3
    • 6
  • Soo Hwang Teo
    • 1
    • 4
  1. 1.Cancer Research MalaysiaSubang JayaMalaysia
  2. 2.Department of Applied Mathematics, Faculty of EngineeringUniversity of Nottingham Malaysia CampusSemenyihMalaysia
  3. 3.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  4. 4.Breast Cancer Research Unit, Faculty of Medicine, University Malaya Cancer Research InstituteUniversity of MalayaKuala LumpurMalaysia
  5. 5.Biomedical Imaging DepartmentUniversity Malaya Medical CentreKuala LumpurMalaysia
  6. 6.Department of RadiologySouth General HospitalStockholmSweden

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