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Mammographic breast density and breast cancer risk by menopausal status, postmenopausal hormone use and a family history of breast cancer

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Abstract

Purpose

Few studies have investigated the association between breast density and breast cancer by a family history of breast cancer, menopausal status, and postmenopausal hormone use (PMH). We investigated if associations of breast density and breast cancer differ according to the status of these risk factors.

Methods

This study included 1,481 incident breast cancer cases diagnosed within the Nurses’ Health Study I and II cohorts and 2,779 matched controls. Breast density was measured from digitized film images with computerized techniques. Information on breast cancer risk factors was obtained prospectively from the biennial questionnaires before the date of the cancer diagnosis for cancer cases and their matched controls. The data were analyzed with logistic regression.

Results

Breast cancer risk increased with increasing percent breast density in all strata (p for trend in all subsets <0.0001). The density-related risk of breast cancer was similar in women with and without a family history (OR = 4.00 [95 % CI 2.01–7.94] vs. 3.71 [95 % CI 2.79–4.94] for density ≥50 % vs. <10 %, p for interaction = 0.53). The magnitude of the association between density and breast cancer risk, however, appeared to be stronger in premenopausal women than in postmenopausal women without PMH history (OR = 5.49 [95 % CI 2.44–12.39] vs. 3.02 [95 % CI 1.62–5.63] for density ≥50 % vs. <10 %, p-heterogeneity = 0.17) and appeared to be stronger in postmenopausal women currently using hormones compared with postmenopausal women who never used PMH (OR = 4.50 [95 % CI 2.99–6.78] vs. 3.02, p-heterogeneity = 0.20) or with past hormone use (OR = 4.50 vs. 3.71 [95 % CI 1.90–7.23], p-heterogeneity = 0.23).

Conclusions

Findings on associations by menopausal status/hormone use are suggestive and should be examined in additional larger studies.

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Acknowledgments

We thank the participants and staff of the Nurses’ Health Study cohort, for their valuable contributions. We thank the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The study sponsors had no role in the design of the study; the collection, analysis, and interpretation of the data; the writing of the manuscript; or the decision to submit the manuscript for publication. Financial support was received from Public Health Service Grants CA131332, CA087969, CA050385 from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services, and Breast Cancer Research Foundation. Dr. Colditz is supported in part by an American Cancer Society Cissy Hornung Clinical Research Professorship.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA

    Lusine Yaghjyan & Graham A. Colditz

  2. Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA

    Graham A. Colditz

  3. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA

    Bernard Rosner & Rulla M. Tamimi

Authors
  1. Lusine Yaghjyan
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  2. Graham A. Colditz
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  3. Bernard Rosner
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  4. Rulla M. Tamimi
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Correspondence to Rulla M. Tamimi.

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Yaghjyan, L., Colditz, G.A., Rosner, B. et al. Mammographic breast density and breast cancer risk by menopausal status, postmenopausal hormone use and a family history of breast cancer. Cancer Causes Control 23, 785–790 (2012). https://doi.org/10.1007/s10552-012-9936-7

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  • DOI: https://doi.org/10.1007/s10552-012-9936-7

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