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Adiposity during early adulthood, changes in adiposity during adulthood, attained adiposity, and mammographic density among premenopausal women



We investigated the associations of adolescent adiposity, changes in adiposity during adulthood, and attained adiposity with volumetric mammographic density measures.


We recruited 383 premenopausal women who had a routine screening mammogram at the Breast Health Center, Washington University in St. Louis, MO from December 2015 to October 2016. Trained research personnel assessed current adiposity measures. Weight at ages 18 and 30 were self-reported. We evaluated mammographic density measures: volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV) using Volpara. Multivariable linear regression models were used to evaluate the associations of adiposity measures with volumetric mammographic density measures.


All attained adiposity measures, BMI at age 18, age 30, and weight change were significantly inversely associated with VPD, and positively associated with DV and NDV. One unit increase in body fat % was associated with a 4.9% decrease in VPD and a 6.5% increase in NDV (p-values <0.001). For each kilogram increase in weight change from age 18 to attained, VPD decreased by 16.3%, 47.1%, and 58.8% for women who gained 5.1–15, 15.1–25 and >25 kg, respectively, compared to women who gained less than 5 kg during this time period (p-values <0.001). Irrespective of BMI at age 18, VPD significantly decreased and NDV increased among women who were currently obese.


There is a need for mechanistic studies focusing on early adulthood to provide a better understanding of how adiposity in early life relates to mammographic density, and possibly breast cancer development in premenopausal women.

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Fig. 1



Joanne Knight Breast Health Center


Washington University School of Medicine


World Health Organization


Volumetric percent density


Dense volume


Non-dense volume


Body mass index

Body fat %:

Body fat percentage


Standard deviation


Beta coefficient


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We thank the Joanne Knight Breast Health Center (BHC) at the Washington University School of Medicine (WUSM), and Siteman Cancer Center, St. Louis, MO. We thank all study participants and Kellie Imm for project management.


The study is supported by funds from the Susan G. Komen Foundation. ATT is supported by the Susan G. Komen Foundation (CCR15332379), Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital Foundation, and Washington University School of Medicine. GAC is supported by Breast Cancer Research Foundation and the Alvin J. Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis, MO., the Biostatistics Shared Resource. The Siteman Cancer Center is supported in part by an NCI Cancer Center Support Grant #P30 CA091842, Eberlein, PI. The funders had no role in study design, data collection, analysis, interpretation of data, preparation of the report, or decision to publish. All authors had full access to all the data and analyses and had final responsibility for the decision to submit for publication.

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Authors and Affiliations



AA, ATT, and GAC contributed to the design of the study. CA and ATT contributed to data collection. AA and ATT contributed to data review. AA and ATT contributed to data analysis. AA, ATT, and GAC contributed to data interpretation. AA, ATT, CA and GAC contributed to the writing and revision of the report. AA searched the scientific literature, produced the figures and tables, and drafted the manuscript. ATT and GAC contributed to critical revision of the paper. All authors (AA, CA, GAC, and ATT) contributed to review of the report and approved the final submitted version.

Corresponding author

Correspondence to Adetunji T. Toriola.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board at Washington University in Saint Louis and also the Protocol and Review Monitoring Committee (#201505122; approval date: 06/29/15). All patients provided written informed consent to participate.

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Alimujiang, A., Appleton, C., Colditz, G.A. et al. Adiposity during early adulthood, changes in adiposity during adulthood, attained adiposity, and mammographic density among premenopausal women. Breast Cancer Res Treat 166, 197–206 (2017).

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  • Mammographic density
  • Breast cancer
  • Adiposity
  • Body fat
  • BMI
  • Weight change
  • Premenopausal