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Mammographic breast density and survival in women with invasive breast cancer

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Abstract

Purpose

We explored the under-debate association between mammographic breast density (MBD) and survival.

Methods

From the Piedmont Cancer Registry, we identified 693 invasive breast cancer (BC) cases. We analyzed the overall survival in strata of MBD through the Kaplan–Meier method. Using the Cox proportional hazards model, we estimated the hazard ratios (HRs) of death; using the cause-specific hazards regression model, we estimated the HRs of BC-related and other causes of death. Models included term for Breast Imaging-Reporting and Data System (BI-RADS) MBD (categorized as BI-RADS 1 and BI-RADS 2–4) and were adjusted for selected patient and tumour characteristics.

Results

There were 102 deaths, of which 49 were from BC. After 5 years, the overall survival was 69% in BI-RADS 1 and 88% in BI-RADS 2–4 (p < 0.01). Compared to BI-RADS 2–4, the HRs of death for BI-RADS 1 were 1.65 (95% CI 1.06–2.58) in the crude model and 1.35 (95% CI 0.84–2.16) in the fully adjusted model. Compared to BI-RADS 2–4, the fully adjusted HRs for BI-RADS 1 were 1.52 (95% CI 0.74–3.13) for BC-related death and 1.83 (95% CI 0.84–4.00) for the other causes of death.

Conclusion

Higher MBD is one of the strongest independent risk factors for BC, but it seems not to have an unfavorable impact on survival.

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Fig. 1

Data availability

The Piedmont Cancer Registry (Registro Tumori Piemonte–RTP).

Code availability

The data that support the findings of this study are available from the corresponding author, GC, upon reasonable request.

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Acknowledgments

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, University of Milan, Via Celoria 22, 20133, Milan, Italy

    Margherita Pizzato, Greta Carioli & Carlo La Vecchia

  2. Piedmont Cancer Registry, A.O.U, Citta` della Salute e della Scienza di Torino, Turin, Italy

    Stefano Rosso & Roberto Zanetti

  3. Fondo Elena Moroni for Oncology, Turin, Italy

    Roberto Zanetti

Authors
  1. Margherita Pizzato
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  2. Greta Carioli
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  3. Stefano Rosso
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  4. Roberto Zanetti
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  5. Carlo La Vecchia
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by GC, MP, and SR. The first draft of the manuscript was written by MP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Greta Carioli.

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Ethical approval

Data were retrieved upon permission gathered from the local cancer registry that operates under national (22/3/2019 #29) and regional (11/3/2012 #4) laws. The investigation did not involve any human contact, but only record linkage analysis of administrative healthcare databases.

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Pizzato, M., Carioli, G., Rosso, S. et al. Mammographic breast density and survival in women with invasive breast cancer. Cancer Causes Control 33, 1207–1213 (2022). https://doi.org/10.1007/s10552-022-01590-x

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  • DOI: https://doi.org/10.1007/s10552-022-01590-x

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