Mammographic density phenotypes and risk of breast cancer: a meta-analysis

Andreas Pettersson, Rebecca E Graff, Giske Ursin, Isabel Dos Santos Silva, Valerie A McCormack, Laura Baglietto, Celine Vachon, Marije F Bakker, Graham Giles, Kee Seng Chia, Kamila Czene, Louise Eriksson, Per Hall, Mikael Hartman, Ruth M L Warren, Gregory Hislop, Anna M Chiarelli, John L Hopper, Kavitha Krishnan, Jingmei Li & 10 others Qing Li, Ian S Pagano, Bernard A Rosner, Chia Siong Wong, Christopher G Scott, Jennifer L Stone, Gertraud Maskarinec, Norman Boyd, Carla H Van Gils, Rulla Tamimi

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Fibroglandular breast tissue appears dense on mammogram, whereas fat appears nondense. It is unclear whether absolute or percentage dense area more strongly predicts breast cancer risk and whether absolute nondense area is independently associated with risk. We conducted a meta-analysis of 13 case-control studies providing results from logistic regressions for associations between one standard deviation (SD) increments in mammographic density phenotypes and breast cancer risk. We used random-effects models to calculate pooled odds ratios and 95% confidence intervals (CIs). All tests were two-sided with P less than .05 considered to be statistically significant. Among premenopausal women (n = 1776 case patients; n = 2834 control subjects), summary odds ratios were 1.37 (95% CI = 1.29 to 1.47) for absolute dense area, 0.78 (95% CI = 0.71 to 0.86) for absolute nondense area, and 1.52 (95% CI = 1.39 to 1.66) for percentage dense area when pooling estimates adjusted for age, body mass index, and parity. Corresponding odds ratios among postmenopausal women (n = 6643 case patients; n = 11187 control subjects) were 1.38 (95% CI = 1.31 to 1.44), 0.79 (95% CI = 0.73 to 0.85), and 1.53 (95% CI = 1.44 to 1.64). After additional adjustment for absolute dense area, associations between absolute nondense area and breast cancer became attenuated or null in several studies and summary odds ratios became 0.82 (95% CI = 0.71 to 0.94; P heterogeneity = .02) for premenopausal and 0.85 (95% CI = 0.75 to 0.96; P heterogeneity < .01) for postmenopausal women. The results suggest that percentage dense area is a stronger breast cancer risk factor than absolute dense area. Absolute nondense area was inversely associated with breast cancer risk, but it is unclear whether the association is independent of absolute dense area.

Original languageEnglish
Article numberdju078
JournalJournal of the National Cancer Institute
Volume106
Issue number5
DOIs
Publication statusPublished - 2014

Cite this

Pettersson, A., Graff, R. E., Ursin, G., Silva, I. D. S., McCormack, V. A., Baglietto, L., ... Tamimi, R. (2014). Mammographic density phenotypes and risk of breast cancer: a meta-analysis. Journal of the National Cancer Institute, 106(5), [dju078]. https://doi.org/10.1093/jnci/dju078
Pettersson, Andreas ; Graff, Rebecca E ; Ursin, Giske ; Silva, Isabel Dos Santos ; McCormack, Valerie A ; Baglietto, Laura ; Vachon, Celine ; Bakker, Marije F ; Giles, Graham ; Chia, Kee Seng ; Czene, Kamila ; Eriksson, Louise ; Hall, Per ; Hartman, Mikael ; Warren, Ruth M L ; Hislop, Gregory ; Chiarelli, Anna M ; Hopper, John L ; Krishnan, Kavitha ; Li, Jingmei ; Li, Qing ; Pagano, Ian S ; Rosner, Bernard A ; Wong, Chia Siong ; Scott, Christopher G ; Stone, Jennifer L ; Maskarinec, Gertraud ; Boyd, Norman ; Van Gils, Carla H ; Tamimi, Rulla. / Mammographic density phenotypes and risk of breast cancer : a meta-analysis. In: Journal of the National Cancer Institute. 2014 ; Vol. 106, No. 5.
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title = "Mammographic density phenotypes and risk of breast cancer: a meta-analysis",
abstract = "Fibroglandular breast tissue appears dense on mammogram, whereas fat appears nondense. It is unclear whether absolute or percentage dense area more strongly predicts breast cancer risk and whether absolute nondense area is independently associated with risk. We conducted a meta-analysis of 13 case-control studies providing results from logistic regressions for associations between one standard deviation (SD) increments in mammographic density phenotypes and breast cancer risk. We used random-effects models to calculate pooled odds ratios and 95{\%} confidence intervals (CIs). All tests were two-sided with P less than .05 considered to be statistically significant. Among premenopausal women (n = 1776 case patients; n = 2834 control subjects), summary odds ratios were 1.37 (95{\%} CI = 1.29 to 1.47) for absolute dense area, 0.78 (95{\%} CI = 0.71 to 0.86) for absolute nondense area, and 1.52 (95{\%} CI = 1.39 to 1.66) for percentage dense area when pooling estimates adjusted for age, body mass index, and parity. Corresponding odds ratios among postmenopausal women (n = 6643 case patients; n = 11187 control subjects) were 1.38 (95{\%} CI = 1.31 to 1.44), 0.79 (95{\%} CI = 0.73 to 0.85), and 1.53 (95{\%} CI = 1.44 to 1.64). After additional adjustment for absolute dense area, associations between absolute nondense area and breast cancer became attenuated or null in several studies and summary odds ratios became 0.82 (95{\%} CI = 0.71 to 0.94; P heterogeneity = .02) for premenopausal and 0.85 (95{\%} CI = 0.75 to 0.96; P heterogeneity < .01) for postmenopausal women. The results suggest that percentage dense area is a stronger breast cancer risk factor than absolute dense area. Absolute nondense area was inversely associated with breast cancer risk, but it is unclear whether the association is independent of absolute dense area.",
author = "Andreas Pettersson and Graff, {Rebecca E} and Giske Ursin and Silva, {Isabel Dos Santos} and McCormack, {Valerie A} and Laura Baglietto and Celine Vachon and Bakker, {Marije F} and Graham Giles and Chia, {Kee Seng} and Kamila Czene and Louise Eriksson and Per Hall and Mikael Hartman and Warren, {Ruth M L} and Gregory Hislop and Chiarelli, {Anna M} and Hopper, {John L} and Kavitha Krishnan and Jingmei Li and Qing Li and Pagano, {Ian S} and Rosner, {Bernard A} and Wong, {Chia Siong} and Scott, {Christopher G} and Stone, {Jennifer L} and Gertraud Maskarinec and Norman Boyd and {Van Gils}, {Carla H} and Rulla Tamimi",
year = "2014",
doi = "10.1093/jnci/dju078",
language = "English",
volume = "106",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
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Pettersson, A, Graff, RE, Ursin, G, Silva, IDS, McCormack, VA, Baglietto, L, Vachon, C, Bakker, MF, Giles, G, Chia, KS, Czene, K, Eriksson, L, Hall, P, Hartman, M, Warren, RML, Hislop, G, Chiarelli, AM, Hopper, JL, Krishnan, K, Li, J, Li, Q, Pagano, IS, Rosner, BA, Wong, CS, Scott, CG, Stone, JL, Maskarinec, G, Boyd, N, Van Gils, CH & Tamimi, R 2014, 'Mammographic density phenotypes and risk of breast cancer: a meta-analysis' Journal of the National Cancer Institute, vol. 106, no. 5, dju078. https://doi.org/10.1093/jnci/dju078

Mammographic density phenotypes and risk of breast cancer : a meta-analysis. / Pettersson, Andreas; Graff, Rebecca E; Ursin, Giske; Silva, Isabel Dos Santos; McCormack, Valerie A; Baglietto, Laura; Vachon, Celine; Bakker, Marije F; Giles, Graham; Chia, Kee Seng; Czene, Kamila; Eriksson, Louise; Hall, Per; Hartman, Mikael; Warren, Ruth M L; Hislop, Gregory; Chiarelli, Anna M; Hopper, John L; Krishnan, Kavitha; Li, Jingmei; Li, Qing; Pagano, Ian S; Rosner, Bernard A; Wong, Chia Siong; Scott, Christopher G; Stone, Jennifer L; Maskarinec, Gertraud; Boyd, Norman; Van Gils, Carla H; Tamimi, Rulla.

In: Journal of the National Cancer Institute, Vol. 106, No. 5, dju078, 2014.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - Mammographic density phenotypes and risk of breast cancer

T2 - a meta-analysis

AU - Pettersson, Andreas

AU - Graff, Rebecca E

AU - Ursin, Giske

AU - Silva, Isabel Dos Santos

AU - McCormack, Valerie A

AU - Baglietto, Laura

AU - Vachon, Celine

AU - Bakker, Marije F

AU - Giles, Graham

AU - Chia, Kee Seng

AU - Czene, Kamila

AU - Eriksson, Louise

AU - Hall, Per

AU - Hartman, Mikael

AU - Warren, Ruth M L

AU - Hislop, Gregory

AU - Chiarelli, Anna M

AU - Hopper, John L

AU - Krishnan, Kavitha

AU - Li, Jingmei

AU - Li, Qing

AU - Pagano, Ian S

AU - Rosner, Bernard A

AU - Wong, Chia Siong

AU - Scott, Christopher G

AU - Stone, Jennifer L

AU - Maskarinec, Gertraud

AU - Boyd, Norman

AU - Van Gils, Carla H

AU - Tamimi, Rulla

PY - 2014

Y1 - 2014

N2 - Fibroglandular breast tissue appears dense on mammogram, whereas fat appears nondense. It is unclear whether absolute or percentage dense area more strongly predicts breast cancer risk and whether absolute nondense area is independently associated with risk. We conducted a meta-analysis of 13 case-control studies providing results from logistic regressions for associations between one standard deviation (SD) increments in mammographic density phenotypes and breast cancer risk. We used random-effects models to calculate pooled odds ratios and 95% confidence intervals (CIs). All tests were two-sided with P less than .05 considered to be statistically significant. Among premenopausal women (n = 1776 case patients; n = 2834 control subjects), summary odds ratios were 1.37 (95% CI = 1.29 to 1.47) for absolute dense area, 0.78 (95% CI = 0.71 to 0.86) for absolute nondense area, and 1.52 (95% CI = 1.39 to 1.66) for percentage dense area when pooling estimates adjusted for age, body mass index, and parity. Corresponding odds ratios among postmenopausal women (n = 6643 case patients; n = 11187 control subjects) were 1.38 (95% CI = 1.31 to 1.44), 0.79 (95% CI = 0.73 to 0.85), and 1.53 (95% CI = 1.44 to 1.64). After additional adjustment for absolute dense area, associations between absolute nondense area and breast cancer became attenuated or null in several studies and summary odds ratios became 0.82 (95% CI = 0.71 to 0.94; P heterogeneity = .02) for premenopausal and 0.85 (95% CI = 0.75 to 0.96; P heterogeneity < .01) for postmenopausal women. The results suggest that percentage dense area is a stronger breast cancer risk factor than absolute dense area. Absolute nondense area was inversely associated with breast cancer risk, but it is unclear whether the association is independent of absolute dense area.

AB - Fibroglandular breast tissue appears dense on mammogram, whereas fat appears nondense. It is unclear whether absolute or percentage dense area more strongly predicts breast cancer risk and whether absolute nondense area is independently associated with risk. We conducted a meta-analysis of 13 case-control studies providing results from logistic regressions for associations between one standard deviation (SD) increments in mammographic density phenotypes and breast cancer risk. We used random-effects models to calculate pooled odds ratios and 95% confidence intervals (CIs). All tests were two-sided with P less than .05 considered to be statistically significant. Among premenopausal women (n = 1776 case patients; n = 2834 control subjects), summary odds ratios were 1.37 (95% CI = 1.29 to 1.47) for absolute dense area, 0.78 (95% CI = 0.71 to 0.86) for absolute nondense area, and 1.52 (95% CI = 1.39 to 1.66) for percentage dense area when pooling estimates adjusted for age, body mass index, and parity. Corresponding odds ratios among postmenopausal women (n = 6643 case patients; n = 11187 control subjects) were 1.38 (95% CI = 1.31 to 1.44), 0.79 (95% CI = 0.73 to 0.85), and 1.53 (95% CI = 1.44 to 1.64). After additional adjustment for absolute dense area, associations between absolute nondense area and breast cancer became attenuated or null in several studies and summary odds ratios became 0.82 (95% CI = 0.71 to 0.94; P heterogeneity = .02) for premenopausal and 0.85 (95% CI = 0.75 to 0.96; P heterogeneity < .01) for postmenopausal women. The results suggest that percentage dense area is a stronger breast cancer risk factor than absolute dense area. Absolute nondense area was inversely associated with breast cancer risk, but it is unclear whether the association is independent of absolute dense area.

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DO - 10.1093/jnci/dju078

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JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

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Pettersson A, Graff RE, Ursin G, Silva IDS, McCormack VA, Baglietto L et al. Mammographic density phenotypes and risk of breast cancer: a meta-analysis. Journal of the National Cancer Institute. 2014;106(5). dju078. https://doi.org/10.1093/jnci/dju078