This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Haars, G. Articles by Peeters, P. H.M. Search for Related Content PubMed PubMed Citation Articles by Haars, G. Articles by Peeters, P. H.M.

Measurements of Breast Density: No Ratio for a Ratio

Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands

Requests for reprints: Gerco Haars, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum, P.O. Box 85500, 3508 GA Utrecht, the Netherlands. Phone: 31-30-253-8097; Fax: 31-30-253-9028. E-mail: G.Haars{at}umcutrecht.nl

Breast density, as visible on mammograms, is generally assessed as the occupied percentage of the breast and is a risk factor for breast cancer. Various studies have looked into the causation and alteration of relative density but the relation of a determinant with a relative measure does not allow a direct etiologic interpretation. It was our goal to compare the effects of known determinants on relative density and the absolute amounts of dense and nondense tissues. We measured the absolute and relative densities in a population of 418 postmenopausal women participating in a breast cancer screening program. The occupied surface area was calculated after manually tracing the contours of the tissues on digitized mammograms. Information on determinants was available through physical examination and questionnaires. Data were analyzed by multivariate linear regression. Age and parity were found to decrease the amount of dense tissue and the ages at menarche and menopause were found to increase it (R² = 13%). The amount of nondense tissue was increased by higher body mass index (BMI), age, and parity (R² = 43%). Relative density was affected by a combination of these factors (R² = 29%) with directionalities of effects that are comparable to those of dense tissue. However, the magnitudes of these effects were the resultant of the effects on dense and nondense tissues. The influence of BMI on relative density was completely due to an effect on nondense tissue. Although relative density is a relevant prognostic factor, inferences about the etiology of breast density should be made on the basis of absolute measures.

This article has been cited by other articles:

				J. A. Douglas, M.-H. Roy-Gagnon, C. Zhou, B. D. Mitchell, A. R. Shuldiner, H.-P. Chan, and M. A. Helvie Mammographic Breast Density--Evidence for Genetic Correlations with Established Breast Cancer Risk Factors Cancer Epidemiol. Biomarkers Prev., December 1, 2008; 17(12): 3509 - 3516. [Abstract] [Full Text] [PDF]

				M. Verheus, C. H. van Gils, S. Kreijkamp-Kaspers, L. Kok, P. H.M. Peeters, D. E. Grobbee, and Y. T. van der Schouw Soy Protein Containing Isoflavones and Mammographic Density in a Randomized Controlled Trial in Postmenopausal Women Cancer Epidemiol. Biomarkers Prev., October 1, 2008; 17(10): 2632 - 2638. [Abstract] [Full Text] [PDF]

				K. Ghosh, K. R. Brandt, T. A. Sellers, C. Reynolds, C. G. Scott, S. D. Maloney, M. J. Carston, V. S. Pankratz, and C. M. Vachon Association of Mammographic Density with the Pathology of Subsequent Breast Cancer among Postmenopausal Women Cancer Epidemiol. Biomarkers Prev., April 1, 2008; 17(4): 872 - 879. [Abstract] [Full Text] [PDF]

				A. Stuedal, H. Ma, L. Bernstein, M. C. Pike, and G. Ursin Does Breast Size Modify the Association between Mammographic Density and Breast Cancer Risk? Cancer Epidemiol. Biomarkers Prev., March 1, 2008; 17(3): 621 - 627. [Abstract] [Full Text] [PDF]

				T. M. Peters, U. Ekelund, M. Leitzmann, D. Easton, R. Warren, R. Luben, S. Bingham, K.-T. Khaw, and N. J. Wareham Physical Activity and Mammographic Breast Density in the EPIC-Norfolk Cohort Study Am. J. Epidemiol., March 1, 2008; 167(5): 579 - 585. [Abstract] [Full Text] [PDF]

				B. J. Fuhrman, B. E. Teter, M. Barba, C. Byrne, A. Cavalleri, B. J. Grant, P. J. Horvath, D. Morelli, E. Venturelli, and P. C. Muti Equol Status Modifies the Association of Soy Intake and Mammographic Density in a Sample of Postmenopausal Women Cancer Epidemiol. Biomarkers Prev., January 1, 2008; 17(1): 33 - 42. [Abstract] [Full Text] [PDF]

				C. M. Vachon, T. A. Sellers, E. E. Carlson, J. M. Cunningham, C. A. Hilker, R. L. Smalley, D. J. Schaid, L. E. Kelemen, F. J. Couch, and V. S. Pankratz Strong Evidence of a Genetic Determinant for Mammographic Density, a Major Risk Factor for Breast Cancer Cancer Res., September 1, 2007; 67(17): 8412 - 8418. [Abstract] [Full Text] [PDF]

				K. W. Reeves, G. L. Gierach, and F. Modugno Recreational Physical Activity and Mammographic Breast Density Characteristics Cancer Epidemiol. Biomarkers Prev., May 1, 2007; 16(5): 934 - 942. [Abstract] [Full Text] [PDF]

				M. Verheus, P. H.M. Peeters, R. Kaaks, P. A.H. van Noord, D. E. Grobbee, and C. H. van Gils Premenopausal Insulin-Like Growth Factor-I Serum Levels and Changes in Breast Density over Menopause Cancer Epidemiol. Biomarkers Prev., March 1, 2007; 16(3): 451 - 457. [Abstract] [Full Text] [PDF]

				C. M. Vachon, K. R. Brandt, K. Ghosh, C. G. Scott, S. D. Maloney, M. J. Carston, V. S. Pankratz, and T. A. Sellers Mammographic Breast Density as a General Marker of Breast Cancer Risk Cancer Epidemiol. Biomarkers Prev., January 1, 2007; 16(1): 43 - 49. [Abstract] [Full Text] [PDF]

				G. Maskarinec, I. Pagano, G. Lurie, and L. N. Kolonel A longitudinal investigation of mammographic density: the multiethnic cohort. Cancer Epidemiol. Biomarkers Prev., April 1, 2006; 15(4): 732 - 739. [Abstract] [Full Text] [PDF]

				F. J.B. van Duijnhoven, P. H.M. Peeters, R. M.L. Warren, S. A. Bingham, A. G. Uitterlinden, P. A.H. van Noord, E. M. Monninkhof, D. E. Grobbee, and C. H. van Gils Influence of Estrogen Receptor {alpha} and Progesterone Receptor Polymorphisms on the Effects of Hormone Therapy on Mammographic Density. Cancer Epidemiol. Biomarkers Prev., March 1, 2006; 15(3): 462 - 467. [Abstract] [Full Text] [PDF]