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Breast Cancer Research
Published in: Breast Cancer Research 1/2017

Open Access 01-12-2017 | Research Article

Association between mammographic breast density and histologic features of benign breast disease

Authors: Karthik Ghosh, Robert A. Vierkant, Ryan D. Frank, Stacey Winham, Daniel W. Visscher, Vernon S. Pankratz, Christopher G. Scott, Kathleen Brandt, Mark E. Sherman, Derek C. Radisky, Marlene H. Frost, Lynn C. Hartmann, Amy C. Degnim, Celine M. Vachon

Published in: Breast Cancer Research | Issue 1/2017

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Abstract

Background

Over 40% of women undergoing breast screening have mammographically dense breasts. Elevated mammographic breast density (MBD) is an established breast cancer risk factor and is known to mask tumors within the dense tissue. However, the association of MBD with high risk benign breast disease (BBD) is unknown.

Method

We analyzed data for 3400 women diagnosed with pathologically confirmed BBD in the Mayo Clinic BBD cohort from 1985–2001, with a clinical MBD measure (either parenchymal pattern (PP) or Breast Imaging Reporting and Data Systems (BI-RADS) density) and expert pathology review. Risk factor information was collected from medical records and questionnaires. MBD was dichotomized as dense (PP classification P2 or DY, or BI-RADS classification c or d) or non-dense (PP classification N1 or P1, or BI-RADS classification a or b). Associations of clinical and histologic characteristics with MBD were examined using logistic regression analysis to estimate odds ratios (ORs) with 95% confidence intervals (CIs).

Results

Of 3400 women in the study, 2163 (64%) had dense breasts. Adjusting for age and body mass index (BMI), there were positive associations of dense breasts with use of hormone therapy (HT), lack of lobular involution, presence of atypical lobular hyperplasia (ALH), histologic fibrosis, columnar cell hyperplasia/flat epithelia atypia (CCH/FEA), sclerosing adenosis (SA), cyst, usual ductal hyperplasia, and calcifications. In fully adjusted multivariate models, HT (1.3, 95% CI 1.1–1.5), ALH (1.5, 95% CI 1.0–2.2), lack of lobular involution (OR 1.6, 95% CI 1.2–2.1, compared to complete involution), fibrosis (OR 2.2, 95% CI 1.9–2.6) and CCH/FEA (OR 1.3, 95% CI 1.0–1.6) remained significantly associated with high MBD.

Conclusion

Our findings support an association between high risk BBD and high MBD, suggesting that risks associated with the latter may act early in breast carcinogenesis.
Appendix
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Metadata
Title
Association between mammographic breast density and histologic features of benign breast disease
Authors
Karthik Ghosh
Robert A. Vierkant
Ryan D. Frank
Stacey Winham
Daniel W. Visscher
Vernon S. Pankratz
Christopher G. Scott
Kathleen Brandt
Mark E. Sherman
Derek C. Radisky
Marlene H. Frost
Lynn C. Hartmann
Amy C. Degnim
Celine M. Vachon
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 1/2017
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/s13058-017-0922-6

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