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Mammographic density and breast cancer risk in White and African American Women

  • Epidemiology
  • Published:
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Abstract

Mammographic density is a strong risk factor for breast cancer, but limited data are available in African American (AA) women. We examined the association between mammographic density and breast cancer risk in AA and white women. Cases (n = 491) and controls (n = 528) were from the Carolina Breast Cancer Study (CBCS) who also had mammograms recorded in the Carolina Mammography Registry (CMR). Mammographic density was reported to CMR using Breast Imaging Reporting and Data System (BI-RADS) categories. Increasing mammographic density was associated with increased breast cancer risk among all women. After adjusting for potential confounders, a monotonically increasing risk of breast cancer was observed between the highest versus the lowest BI-RADS density categories [OR = 2.45, (95 % confidence interval: 0.99, 6.09)]. The association was stronger in whites, with ~40 % higher risk among those with extremely dense breasts compared to those with scattered fibroglandular densities [1.39, (0.75, 2.55)]. In AA women, the same comparison suggested lower risk [0.75, (0.30, 1.91)]. Because age, obesity, and exogenous hormones have strong associations with breast cancer risk, mammographic density, and race in the CBCS, effect measure modification by these factors was considered. Consistent with previous literature, density-associated risk was greatest among those with BMI > 30 and current hormone users (P value = 0.02 and 0.01, respectively). In the CBCS, mammographic density is associated with increased breast cancer risk, with some suggestion of effect measure modification by race, although results were not statistically significant. However, exposures such as BMI and hormone therapy may be important modifiers of this association and merit further investigation.

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Abbreviations

AA:

African American

BI-RADS:

Breast Imaging Reporting and Data System

BMI:

Body mass index

CBCS:

Carolina Breast Cancer Study

CI:

Confidence interval

CMR:

Carolina Mammography Registry

HT:

Hormone therapy

LRT:

Likelihood ratio test

NHLBI:

National Heart, Lung, and Blood Institute

OR:

Odds ratio

WHR:

Waist-to-hip ratio

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Acknowledgments

The authors are grateful to Jessica Tse and Robert Christopher Allis for their assistance with data management and data analysis for this manuscript. This research was supported [in part] by the Intramural Research Program of the NIH and the National Cancer Institute. M.A.T was supported by the National Institutes for Environmental Health Sciences and National Cancer Institute Breast Cancer and the Environment Research Program 5U01ES019472-02 and NCI grant 5R01CA138255. R.C.M. and M.A.T are supported by a SPORE in Breast Cancer 5P50CA058233.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Epidemiology, Gillings Global School of Public Health, University of North Carolina, 2104 McGavran-Greenberg, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC, 27599-7435, USA

    Hilda Razzaghi, Melissa A. Troester, Andrew F. Olshan & Robert C. Millikan

  2. Linberger Comprehensive Cancer Center, University of North Carolina, 2104 McGavran-Greenberg, 135 Dauer Drive, Campus Box 7435, Chapel Hill, NC, 27599-7435, USA

    Melissa A. Troester, Andrew F. Olshan & Robert C. Millikan

  3. Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, Suite 550, Room 5016, MSC 7234, Rockville, MD, 20852-7234, USA

    Gretchen L. Gierach

  4. Department of Radiology, School of Medicine, University of North Carolina, 107 Deerfield Trail, Chapel Hill, NC, 27516, USA

    Bonnie C. Yankaskas

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  1. Hilda Razzaghi
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  2. Melissa A. Troester
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  3. Gretchen L. Gierach
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  4. Andrew F. Olshan
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  6. Robert C. Millikan
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Correspondence to Hilda Razzaghi.

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Razzaghi, H., Troester, M.A., Gierach, G.L. et al. Mammographic density and breast cancer risk in White and African American Women. Breast Cancer Res Treat 135, 571–580 (2012). https://doi.org/10.1007/s10549-012-2185-3

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