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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Epidemiology

Mammographic Density and Breast Cancer Risk: Evaluation of a Novel Method of Measuring Breast Tissue Volumes

Norman Boyd, Lisa Martin, Anoma Gunasekara, Olga Melnichouk, Gord Maudsley, Chris Peressotti, Martin Yaffe and Salomon Minkin
Norman Boyd
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Lisa Martin
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Anoma Gunasekara
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Olga Melnichouk
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Gord Maudsley
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Chris Peressotti
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Martin Yaffe
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Salomon Minkin
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DOI: 10.1158/1055-9965.EPI-09-0107 Published June 2009
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    Figure 1.

    Flowchart of recruitment of cases and controls.

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    Figure 2.

    Observed distributions and correlations between volume and area breast measurements for case-control triplets (n = 813). Rs, a Spearman correlation coefficient.

Tables

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  • Table 1.

    Selected characteristics of all subjects (n = 1,020) by case-control status

    Cases (n = 364)Controls
    Matched by machine (n = 359)P*Not matched by machine (n = 297)P*
    Risk factors
        Height (cm)162.6 (6.9)163.1 (6.6)0.32163.4 (6.2)0.12
        Weight (kg)68.3 (14.4) n = 36268.0 (14.6) n = 3580.7568.3 (14.7)0.96
        BMI (kg/m2)25.8 (5.2) n = 36225.6 (5.5) n = 3580.5025.6 (5.2)0.47
        Age at mammogram (y)59.6 (11.0)59.5 (11.0)0.9058.4 (11.1)0.17
        Age at menarche (y)12.7 (1.4) n = 36112.8 (1.5)0.5112.7 (1.4) n = 2950.93
        Parity (% parous)70.976.00.1269.70.74
        Age at birth of 1st child (y)26.3 (5.0) n = 25826.6 (5.4) n = 2740.5326.6 (5.6) n = 2060.54
        No. of live births1.7 (1.4)1.8 (1.4)0.201.6 (1.4)0.76
        Menopausal status (% postmenopausal)68.0 (n = 363)69.90.5969.6 (n = 296)0.67
        Age at menopause (y)49.4 (6.2) n = 21147.7 (6.4) n = 2200.0148.1 (6.5) n = 1780.05
        HRT ever used (% yes)45.145.5 (n = 358)0.9044.40.88
        Years HRT used (y)4.0 (6.9)4.2 (7.5) n = 3580.693.8 (7.0)0.73
        Breast cancer in 1st degree relatives (% yes)21.6 (n = 361)26.3 (n = 357)0.1423.0 (n = 296)0.68
    Imaging parameters
        Breast thickness (cm)5.4 (1.2)5.4 (1.4)0.925.4 (1.4)0.57
        KVP26.8 (2.0)26.7 (2.0)0.6226.8 (2.1)0.81
        MAS155.3 (48.7)156.0 (57.9)0.85144.9 (52.4)0.01
        Compression force (N)104.7 (32.6)103.9 (31.8)0.74101.3 (33.0)0.20
    Volume breast measurements
        Percent dense volume (%)11.3 (16.1)9.9 (14.6)0.237.7 (12.9)0.001
        Dense volume (cm3)57.9 (76.6)53.6 (86.5)0.2538.9 (60.4)0.0001
        Total volume (cm3)725.2 (360.8)761.6 (417.2)0.44752.7 (406.8)0.58
    Area breast measurements
        Percent dense area (%)33.3 (20.5)30.3 (19.7)0.0730.1 (19.9)0.05
        Dense area (cm2)40.8 (26.9)38.4 (27.3)0.2136.3 (23.4)0.04
        Total area (cm2)141.5 (61.0)146.4 (64.2)0.31144.6 (63.4)0.55
    • NOTE: Shown are mean (SD) and percentage for, respectively, continuous and categorical variables.

    • HRT, hormone replacement therapy; KVP, kilovoltage peak; MAS, milliampere seconds.

    • ↵* Two-sided two-sample t test for continuous variables, and χ2 test for categorical variables. Cubic root and square root transformations were applied to, respectively, volume and area breast measurements.

  • Table 2.

    Risk of breast cancer according to quintiles of percent and absolute density for all subjects (n = 1,020)

    Quintile of percent density
    P*Quintile of absolute density
    P*
    1234512345
    Percent dense volume (%)Dense volume (cm3)
    No. of cases62647578856468618685
    No. of controls142140129126119140136143118119
    OR unadjusted (95% CI)Reference1.05 (0.7, 1.6)1.33 (0.9, 2.0)1.42 (0.9, 2.1)1.64 (1.1, 2.5)0.01Reference1.09 (0.7, 1.7)0.93 (0.6, 1.4)1.59 (1.1, 2.4)1.56 (1.0, 2.3)0.1
    OR adjusted for risk factors† (95% CI)Reference1.08 (0.7, 1.6)1.39 (0.9, 2.1)1.60 (1.0, 2.5)1.98 (1.3, 3.1)0.001Reference1.10 (0.7, 1.7)0.98 (0.6, 1.5)1.69 (1.1, 2.6)1.68 (1.1, 2.6)0.003
    Percent dense area (%)Dense area (cm2)
    No. of cases70607676827162697884
    No. of controls134144128128122133142135126120
    OR unadjusted (95% CI)Reference0.80 (0.5, 1.2)1.14 (0.8, 1.8)1.14 (0.8, 1.7)1.29 (0.9, 1.9)0.06Reference0.82 (0.5, 1.2)0.96 (0.6, 1.4)1.16 (0.8, 1.7)1.31 (0.9, 2.0)0.05
    OR adjusted for risk factors† (95% CI)Reference0.92 (0.6, 1.4)1.41 (0.9, 2.2)1.49 (0.9, 2.3)1.86 (1.1, 3.0)0.003Reference0.90 (0.6, 1.4)1.07 (0.7, 1.6)1.29 (0.8, 2.0)1.48 (1.0, 2.3)0.02
    • NOTE: Shown are mean (SD) and percentage for, respectively, continuous and categorical variables.

    • ↵* Unconditional logistic regression analysis. P value is from a test of linear trend with quintiles as an ordinary variable in the model.

    • ↵† Age at mammogram (y), age at first birth (y), weight (kg), height (cm), menopausal status (premenopausal, postmenopausal), and parity (parous, nonparous).

  • Table 3.

    Risk of breast cancer according to quintiles of percent and absolute density for case-control triplets (n = 813)

    Quintile of percent density
    P*Quintile of absolute density
    P*
    1234512345
    Percent dense volume (%)Dense volume (cm3)
    No. of cases44455659674549466566
    No. of controls119117107103961181131179797
    OR unadjusted (95% CI)Reference1.04 (0.6, 1.7)1.42 (0.9, 2.3)1.55 (1.0, 2.5)1.89 (1.2, 3.0)0.002Reference1.14 (0.7, 1.8)1.03 (0.6, 1.7)1.76 (1.1, 2.8)1.78 (1.1, 2.8)0.002
    OR adjusted for risk factors† (95% CI)Reference1.06 (0.6, 1.7)1.48 (0.9, 2.4)1.72 (1.0, 2.8)2.21 (1.3, 3.7)0.001Reference1.15 (0.7, 1.9)1.04 (0.6, 1.7)1.82 (1.1, 2.9)1.86 (1.1, 3.0)0.003
    Percent dense area (%)Dense area (cm2)
    No. of cases41456856614046556763
    No. of controls1221179510610212311610895100
    OR unadjusted (95% CI)Reference1.14 (0.7, 1.9)2.13 (1.3, 3.4)1.57 (1.0, 2.5)1.78 (1.1, 2.9)0.01Reference1.22 (0.7, 2.0)1.57 (1.0, 2.5)2.17 (1.3, 3.5)1.94 (1.2, 3.1)0.0005
    OR adjusted for risk factors† (95% CI)Reference1.34 (0.8, 2.2)2.60 (1.6, 4.3)2.04 (1.2, 3.5)2.40 (1.3, 4.3)0.002Reference1.35 (0.8, 2.3)1.74 (1.0, 2.9)2.35 (1.4, 3.9)2.11 (1.3, 3.5)0.0005
    • NOTE: Shown are mean (SD) and percentage for, respectively, continuous and categorical variables.

    • ↵* Unconditional logistic regression analysis. P value is from a test of linear trend with quintiles as an ordinary variable in the model.

    • ↵† Age at mammogram (y), age at first birth (y), weight (kg), height (cm), menopausal status (premenopausal, postmenopausal), and parity (parous, nonparous).

  • Table 4.

    Risk of breast cancer according to continuous percent and absolute density for all subjects (n = 1,020)

    Regression coefficientPRegression coefficientP
    Percent dense volume* (%)Dense volume* (cm3)
    UnadjustedSeparate predictors0.18140.010.11970.005
    Both in the model0.14270.110.10710.04
    Adjusted for risk factors†Separate predictors0.25490.0010.13720.003
    Both in the model0.15730.080.11060.03
    Percent dense area‡ (%)Dense area‡ (cm2)
    UnadjustedSeparate predictors0.07030.030.05680.06
    Both in the model0.02860.490.01600.65
    Adjusted for risk factors†Separate predictors0.14780.00050.07600.02
    Both in the model0.10790.030.03820.30
    • NOTE: Unconditional logistic regression analysis.

    • ↵* Cubic root transformed.

    • ↵† Age at mammogram (y), age at first birth (y), weight (kg), height (cm), menopausal status (premenopausal, postmenopausal), and parity (parous, nonparous).

    • ↵‡ Square root transformed.

  • Table 5.

    Risk of breast cancer according to continuous percent and absolute density for all case-control triplets (n = 813)

    Regression coefficientPRegression coefficientP
    Percent dense volume* (%)Dense volume* (cm3)
    UnadjustedSeparate predictors0.22520.0050.15970.001
    Both in the model0.08730.410.09790.10
    Adjusted for risk factors†Separate predictors0.27970.0030.17050.002
    Both in the model0.11500.290.10620.09
    Percent dense area‡ (%)Dense area‡ (cm2)
    UnadjustedSeparate predictors0.12620.0010.11480.001
    Both in the model0.09930.050.07590.07
    Adjusted for risk factors†Separate predictors0.2041<0.00010.12270.001
    Both in the model0.17420.0020.08580.05
    • NOTE: Unconditional logistic regression analysis.

    • ↵* Cubic root transformed.

    • ↵† Age at mammogram (y), age at first birth (y), weight (kg), height (cm), menopausal status (premenopausal, postmenopausal), and parity (parous, nonparous).

    • ↵‡ Square root transformed.

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Cancer Epidemiology Biomarkers & Prevention: 18 (6)
June 2009
Volume 18, Issue 6
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Mammographic Density and Breast Cancer Risk: Evaluation of a Novel Method of Measuring Breast Tissue Volumes
Norman Boyd, Lisa Martin, Anoma Gunasekara, Olga Melnichouk, Gord Maudsley, Chris Peressotti, Martin Yaffe and Salomon Minkin
Cancer Epidemiol Biomarkers Prev June 1 2009 (18) (6) 1754-1762; DOI: 10.1158/1055-9965.EPI-09-0107

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Mammographic Density and Breast Cancer Risk: Evaluation of a Novel Method of Measuring Breast Tissue Volumes
Norman Boyd, Lisa Martin, Anoma Gunasekara, Olga Melnichouk, Gord Maudsley, Chris Peressotti, Martin Yaffe and Salomon Minkin
Cancer Epidemiol Biomarkers Prev June 1 2009 (18) (6) 1754-1762; DOI: 10.1158/1055-9965.EPI-09-0107
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