Changes in mammographic density over time and the risk of breast cancer: An observational cohort study.

Aged Breast / diagnostic imaging Breast Density Breast Neoplasms / diagnosis Early Detection of Cancer / methods Female Humans Mammography / statistics & numerical data Middle Aged Risk Assessment Risk Factors Spain / epidemiology Time Factors

Breast neoplasms Longitudinal studies Mammographic density Mass screening

Journal

Breast (Edinburgh, Scotland)

ISSN: 1532-3080

Titre abrégé: Breast

Pays: Netherlands

ID NLM: 9213011

Informations de publication

Date de publication:
Aug 2019

Historique:

received: 01 02 2019

revised: 16 04 2019

accepted: 26 04 2019

pubmed: 28 5 2019

medline: 15 1 2020

entrez: 28 5 2019

Statut: ppublish

Résumé

The effect of changes in mammographic density over time on the risk of breast cancer remains inconclusive. We used information from four centres of the Breast Cancer Screening Program in Spain in the period 1996-2015. We analysed individual level data from 117,388 women first screened age 50-54, with at least two screening examinations. Breast density was determined using the BI-RADS classification (A to D in increasing order) at earliest and latest screening examination. Adjusted Poisson regression models were used to estimate the relative risk (RR) and 95% confidence intervals (95%CI) of the association between changes in mammographic density and breast cancer risk over time. During an average 5.8 years of follow-up, 1592 (1.36%) women had a breast cancer diagnosis. An increase in density category increased breast cancer risk, and a decrease in density decreased the risk, compared with women who remained in the same BI-RADS category. Women whose density category increased from B to C or B to D had a RR of 1.55 (95%CI = 1.24-1.94) and 2.32 (95%CI = 1.48-3.63), respectively. The RR for women whose density increased from C to D was 1.51 (95%CI = 1.03-2.22). Changes in BI-RADS density were similarly associated with the risk for invasive cancer than for ductal carcinoma in situ. Although a modest proportion of women changed BI-RADS density category, mammographic density changes modulated the risk of breast cancer and identified women at a differential risk. Using two longitudinal measures of BI-RADS density could help target women for risk-based screening strategies.

Sections du résumé

BACKGROUND BACKGROUND

The effect of changes in mammographic density over time on the risk of breast cancer remains inconclusive.

METHODS METHODS

We used information from four centres of the Breast Cancer Screening Program in Spain in the period 1996-2015. We analysed individual level data from 117,388 women first screened age 50-54, with at least two screening examinations. Breast density was determined using the BI-RADS classification (A to D in increasing order) at earliest and latest screening examination. Adjusted Poisson regression models were used to estimate the relative risk (RR) and 95% confidence intervals (95%CI) of the association between changes in mammographic density and breast cancer risk over time.

RESULTS RESULTS

During an average 5.8 years of follow-up, 1592 (1.36%) women had a breast cancer diagnosis. An increase in density category increased breast cancer risk, and a decrease in density decreased the risk, compared with women who remained in the same BI-RADS category. Women whose density category increased from B to C or B to D had a RR of 1.55 (95%CI = 1.24-1.94) and 2.32 (95%CI = 1.48-3.63), respectively. The RR for women whose density increased from C to D was 1.51 (95%CI = 1.03-2.22). Changes in BI-RADS density were similarly associated with the risk for invasive cancer than for ductal carcinoma in situ.

CONCLUSIONS CONCLUSIONS

Although a modest proportion of women changed BI-RADS density category, mammographic density changes modulated the risk of breast cancer and identified women at a differential risk. Using two longitudinal measures of BI-RADS density could help target women for risk-based screening strategies.

Identifiants

DOI: 10.1016/j.breast.2019.04.007 PMID: 31132476

pubmed: 31132476

pii: S0960-9776(19)30494-1

doi: 10.1016/j.breast.2019.04.007

pii:

doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

Pagination

108-115

Investigateurs

Andrea Burón (A)

Xavier Castells (X)

Laia Domingo (L)

Javier Louro (J)

Margarita Posso (M)

Ana Rodríguez-Arana (A)

Marta Román (M)

Maria Sala (M)

Sònia Servitja (S)

Mar Vernet (M)

Xavier Andreu (X)

Marisa Baré (M)

Llucia Benito (L)

Carmen Vidal (C)

María Jesús Quintana (MJ)

Judit Solà-Roca (J)

Mar Sánchez (M)

Miguel Prieto (M)

Jaume Galceran (J)

Francina Saladié (F)

Joana Ferrer (J)

Josep Alfons Espinàs (JA)

Lupe Peñalva (L)

Isabel Torá-Rocamora (I)

Xavier Bargalló (X)