Breast Cancer Risk by Breast Density, Menopause, and Postmenopausal Hormone Therapy Use
- 20 August 2010
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 28 (24), 3830-3837
- https://doi.org/10.1200/jco.2009.26.4770
Abstract
We determined whether the association between breast density and breast cancer risk and cancer severity differs according to menopausal status and postmenopausal hormone therapy (HT) use. We collected data on 587,369 women who underwent 1,349,027 screening mammography examinations; 14,090 women were diagnosed with breast cancer. We calculated 5-year breast cancer risk from a survival model for subgroups of women classified by their Breast Imaging Reporting and Data System (BIRADS) breast density, age, menopausal status, and current HT use, assuming a body mass index of 25 kg/m2. Odds of advanced (ie, IIb, III, IV) versus early (ie, I, IIa) stage invasive cancer was calculated according to BIRADS density. Breast cancer risk was low among women with low density (BIRADS-1): women age 55 to 59 years, 5-year risk was 0.8% (95% CI, 0.6 to 0.9%) for non-HT users and 0.9% (95% CI, 0.7% to 1.1%) for estrogen and estrogen plus progestin users. Breast cancer risk was high among women with very high density (BIRADS-4), particularly estrogen plus progestin users: women age 55 to 59 years, 5-year risk was 2.4% (95% CI, 2.0% to 2.8%) for non-HT users, 3.0% (95% CI, 2.6% to 3.5%) for estrogen users, and 4.2% (95% CI, 3.7% to 4.6%) for estrogen plus progestin users. Advanced-stage breast cancer risk was increased 1.7-fold for postmenopausal HT users who had very high density (BIRADS-4) compared to those with average density (BIRADS-2). Postmenopausal women with high breast density are at increased risk of breast cancer and should be aware of the added risk of taking HT, especially estrogen plus progestin.This publication has 34 references indexed in Scilit:
- Conjugated Equine Estrogen Influence on Mammographic Density in Postmenopausal Women in a Substudy of the Women's Health Initiative Randomized TrialJournal of Clinical Oncology, 2009
- Association of Mammographic Density with the Pathology of Subsequent Breast Cancer among Postmenopausal WomenCancer Epidemiology, Biomarkers & Prevention, 2008
- Postmenopausal Hormone Therapy and Changes in Mammographic DensityJournal of Clinical Oncology, 2007
- Longitudinal Measurement of Clinical Mammographic Breast Density to Improve Estimation of Breast Cancer RiskJNCI Journal of the National Cancer Institute, 2007
- Mammographic Density as a Surrogate Marker for the Effects of Hormone Therapy on Risk of Breast CancerCancer Epidemiology, Biomarkers & Prevention, 2006
- Partly Conditional Survival Models for Longitudinal DataBiometrics, 2005
- Prognostic Characteristics of Breast Cancer Among Postmenopausal Hormone Users in a Screened PopulationJournal of Clinical Oncology, 2003
- Effects of Estrogen and Estrogen–Progestin on Mammographic Parenchymal DensityAnnals of Internal Medicine, 1999
- Breast Cancer Surveillance Consortium: a national mammography screening and outcomes database.American Journal of Roentgenology, 1997
- Influence of age and parity on the development of the human breastBreast Cancer Research and Treatment, 1992