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Do Body Mass Index and Breast Density Impact Cancer Risk Among Women with Lobular Carcinoma In Situ?

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Both body mass index (BMI) and breast density impact breast cancer risk in the general population. Whether obesity and density represent additive risk factors in women with lobular carcinoma in situ (LCIS) is unknown.

Methods

Patients diagnosed with LCIS from 1988 to 2017 were identified from a prospectively maintained database. BMI was categorized by World Health Organization classification. Density was captured as the mammographic Breast Imaging Reporting and Data System (BIRADS) value. Other covariates included age at LCIS diagnosis, menopausal status, family history, chemoprevention, and prophylactic mastectomy. Cancer-free probability was estimated using the Kaplan–Meier method, and Cox regression models were used for univariable and multivariable analyses.

Results

A total of 1222 women with LCIS were identified. At a median follow-up of 7 years, 179 women developed breast cancer (121 invasive, 58 ductal carcinoma in situ); 5- and 10-year cumulative incidences of breast cancer were 10% and 17%, respectively. In multivariable analysis, increased breast density (BIRADS C/D vs. A/B) was significantly associated with increased hazard of breast cancer (hazard ratio [HR] 2.42, 95% confidence interval [CI] 1.52–3.88), whereas BMI was not. On multivariable analysis, chemoprevention use was associated with a significantly decreased hazard of breast cancer (HR 0.49, 95% CI 0.29–0.84). Exploratory analyses did not demonstrate significant interaction between BMI and menopausal status, BMI and breast density, BMI and chemoprevention use, or breast density and chemoprevention.

Conclusions

Breast cancer risk among women with LCIS is impacted by breast density. These results aid in personalizing risk assessment among women with LCIS and highlight the importance of chemoprevention counseling for risk reduction.

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Acknowledgments

The preparation of this study was funded in part by NIH/NCI Cancer Center Support Grant No. P30 CA008748 to Memorial Sloan Kettering Cancer Center. This study was presented in podium format at the Society of Surgical Oncology 72nd Annual Cancer Symposium, March 27–30, 2019, San Diego, CA. Dr. Tari A. King has received honoraria as a speaker for Genomic Health

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Christina A. Minami MD, MS & Tari A. King MD

  2. Breast Oncology Program, Dana-Farber/Brigham and Women’s Cancer Center, Boston, MA, USA

    Christina A. Minami MD, MS & Tari A. King MD

  3. Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Emily C. Zabor DrPH

  4. Weill Cornell Medical College, New York, NY, USA

    Elizabeth Gilbert BS

  5. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ashley Newman MD, Anna Park PA & Melissa L. Pilewskie MD

  6. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Maxine S. Jochelson MD

Authors
  1. Christina A. Minami MD, MS
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  2. Emily C. Zabor DrPH
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  3. Elizabeth Gilbert BS
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  8. Melissa L. Pilewskie MD
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Correspondence to Melissa L. Pilewskie MD.

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Minami, C.A., Zabor, E.C., Gilbert, E. et al. Do Body Mass Index and Breast Density Impact Cancer Risk Among Women with Lobular Carcinoma In Situ?. Ann Surg Oncol 27, 1844–1851 (2020). https://doi.org/10.1245/s10434-019-08126-9

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  • DOI: https://doi.org/10.1245/s10434-019-08126-9

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