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Mammographic density in relation to tumor biomarkers, molecular subtypes, and mode of detection in breast cancer

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Abstract

Purpose

Mammographic density is an established risk factor for breast cancer; however, the relation to tumor pathological parameters including the androgen receptor and molecular subtypes has not been extensively studied.

Methods

In the Malmö Diet and Cancer Study, 733 invasive breast cancers were diagnosed from 1991 to 2007. Mammographic density was defined qualitatively. Tumor biomarker information including estrogen receptor (ER), progesterone receptor, androgen receptor (AR), human epidermal growth factor 2 (HER2), and Ki67 was collected. Surrogate molecular subtypes were defined as luminal A, luminal B, HER2 positive and triple-negative breast cancer (TNBC).

Results

Among the 632 tumors with mammographic and pathological information, 352 tumors were screening-detected and 280 clinically detected. Higher mammographic density was associated with ER-negative tumors [ORadj 1.93 (1.04–3.59)] and TNBC [ORadj 2.44 (1.01–5.89), luminal A reference], in clinically detected breast cancer. Similarly, higher mammographic density was associated with AR-negative tumors [ORadj 1.77 (0.80–3.93)] in clinically detected breast cancer, though the evidence for this association was weak.

Conclusions

In clinically detected breast cancer, but not in screening-detected, higher mammographic density was associated with ER-negative tumors including TNBC. This study highlights the need for taking mode of detection into consideration when addressing mammographic density and tumor biomarkers.

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Acknowledgments

The authors thank Anna Hwasser for excellent data management, Elise Nilsson for committed assistance with tumor tissue handling, and Lola Anagnostaki for assistance with pathology assessments. This work has received government funding for clinical research within the National Health Services.

Conflict of interest

The authors declare no conflict of interests.

Author information

Authors and Affiliations

  1. Diagnostic Radiology, Department of Translational Medicine, Lund University, Lund, Sweden

    Hanna Sartor & Sophia Zackrisson

  2. Department of Medical Imaging and Physiology Medicine, Skåne University Hospital, Malmö, Sweden

    Hanna Sartor & Sophia Zackrisson

  3. Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden

    Karin Elebro, Linda Hartman & Signe Borgquist

  4. Department of Oncology, Skåne University Hospital, Lund, Sweden

    Signe Borgquist

  5. Regional Cancer Center South, Lund, Sweden

    Linda Hartman

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  1. Hanna Sartor
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  2. Sophia Zackrisson
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  3. Karin Elebro
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  4. Linda Hartman
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  5. Signe Borgquist
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Correspondence to Hanna Sartor.

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Sartor, H., Zackrisson, S., Elebro, K. et al. Mammographic density in relation to tumor biomarkers, molecular subtypes, and mode of detection in breast cancer. Cancer Causes Control 26, 931–939 (2015). https://doi.org/10.1007/s10552-015-0576-6

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  • DOI: https://doi.org/10.1007/s10552-015-0576-6

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