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01-09-2020 | Mammography | Epidemiology

“Are changes in breast density during the menstrual cycle relevant? To what?”

Authors: Jean L. Browne, Natalie Korsun, Lilian Casas, Ignacio Rodriguez, Beatriz Valero, Andreina Rincon, M. Angela Pascual

Published in: Breast Cancer Research and Treatment | Issue 2/2020

Abstract

Purpose

Cancers can be hidden by high breast density (BDen)- the masking effect (ME). BDen is also a modifiable and highly prevalent breast cancer risk (BCR) factor. The purposes of this study were to determine how much glandular volume (GVol), breast volume (BVol) and their ratio: BDen change during the menstrual cycle, and if these changes could affect ME or be relevant to results of interventional studies aiming to diminish BCR using these parameters as surrogates.

Methods

We retrieved GVol, BVol and BDen data values obtained from 39,997 right mammograms performed with photon counting technique of 19,904 premenopausal women who reported their first day of last menses (FDLM). Many women had more than one study included over the years (with a different FDLM) but were not studied longitudinally. We segregated women by age (yearly), divided the menstrual cycle in 4 weeks, and assigned results with respect to the FDLM.

Results

All parameters vary cyclically, with higher values in week 4 (GVol and BDen) or week 1 (BVol). Mean inter-week differences were very small for the three parameters, and diminished with age. However, especially in the youngest women, inter-week differences could be more than 10% for BDen, 15% for GVol, and 50% for BVol.

Conclusion

Small inter-week mean differences almost certainly rule out relevant changes to ME directly attributable to BDen. However, the possibility of large differences during the menstrual cycle in younger women, who are the ideal targets of interventional studies to diminish BCR, might distort results and should be accounted for.

Bae MS, Moon WK, Chang JM, Koo HR, Kim WH, Cho N, …, Seo M (2014) Breast cancer detected with screening US: reasons for nondetection at mammography. Radiology 270(2):369–377. https://doi.org/10.1148/radiol.13130724 CrossRefPubMed

Freer PE (2015) Mammographic breast density: impact on breast cancer risk and implications for screening. Radiographics 35(2):302–315. https://doi.org/10.1148/rg.352140106 CrossRefPubMed

Ursin G, Parisky YR, Pike MC, Spicer DV (2001) Mammographic density changes during the menstrual cycle. Cancer Epidemiol Biomark Prev 10(2):141–142

White E, Velentgas P, Mandelson MT, Lehman CD, Elmore JG, Porter P, Yasui Y, Taplin SH (1998) Variation in mammographic breast density by time in menstrual cycle among women aged 40–49 years. J Natl Cancer Inst 90(12):906–910. https://doi.org/10.1093/jnci/90.12.906 CrossRefPubMed

Miglioretti DL, Walker R, Weaver DL, Buist DSM, Taplin SH, Carney PA, Rosenberg RD, Dignan MB, Zhang ZT, White E (2011) Accuracy of screening mammography varies by week of menstrual cycle. Radiology 258(2):372–379. https://doi.org/10.1148/radiol.10100974/-/DC1 CrossRefPubMedPubMedCentral

Baines CJ (1998) Menstrual cycle variation in mammographic breast density: so who cares? J Natl Cancer Inst 90(12):875–876. https://doi.org/10.1093/jnci/90.12.875 CrossRefPubMed

Baines CJ, Vidmar M, McKeown-Eyssen G, Tibshirani R (1997) Impact of menstrual phase on false-negative mammograms in the Canadian National Breast Screening Study. Cancer 80(4):720–724. https://doi.org/10.1002/(SICI)1097-0142(19970815)80:4<720:AID-CNCR10>3.0.CO;2-V CrossRefPubMed

Engmann NJ, Golmakani MK, Miglioretti DL, Sprague BL, Kerlikowske K (2017) Population-attributable risk proportion of clinical risk factors for breast cancer. JAMA Oncol 3(9):1228–1236. https://doi.org/10.1001/jamaoncol.2016.6326 CrossRefPubMedPubMedCentral

Cuzick J, Warwick J, Pinney E, Warren RML, Duffy SW (2004) Tamoxifen and breast density in women at increased risk of breast cancer. J Natl Cancer Inst 96(8):621–628. https://doi.org/10.1093/jnci/djh106 CrossRefPubMed

10.

Cuzick J, Warwick J, Pinney E, Duffy SW, Cawthorn S, Howell A, …, Warren RML (2011) Tamoxifen-induced reduction in mammographic density and breast cancer risk reduction: a nested case-control study. J Natl Cancer Inst 103(9):744–752. https://doi.org/10.1093/jnci/djr079 CrossRefPubMed

11.

Cuzick J, Sestak I, Cawthorn S, Hamed H, Holli K, Howell A, Forbes JF (2015) Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial. Lancet Oncol 16(1):67–75. https://doi.org/10.1016/S1470-2045(14)71171-4 CrossRefPubMedPubMedCentral

12.

Nyante SJ, Sherman ME, Pfeiffer RM, Berrington De Gonzalez A, Brinton LA, AielloBowles EJ, Hoover RN, Glass A, Gierach GL (2015) Prognostic significance of mammographic density change after initiation of tamoxifen for ER-positive breast cancer. J Natl Cancer Inst 107(3):425. https://doi.org/10.1093/jnci/dju425 CrossRef

13.

Vachon CM, Pankratz VS, Scott CG, Maloney SD, Ghosh K, Brandt KR, …, Sellers TA (2007) Longitudinal trends in mammographic percent density and breast cancer risk. Cancer Epidemiol Biomark Prev 16(5):921–928. https://doi.org/10.1158/1055-9965.EPI-06-1047 CrossRef

14.

Krishnan K, Baglietto L, Stone J, Simpson JA, Severi G, Evans CF, …, Hopper JL (2017) Longitudinal study of mammographic density measures that predict breast cancer risk. Cancer Epidemiol Biomark Prev 26(4):651–660. https://doi.org/10.1158/1055-9965.EPI-16-0499 CrossRef

15.

Winkler NS, Raza S, Mackesy M, Birdwell RL (2015) Breast density: clinical implications and assessment methods. Radiographics 35(2):316–324. https://doi.org/10.1148/rg.352140134 CrossRefPubMed

16.

Johansson H, Von Tiedemann M, Erhard K, Heese H, Ding H, Molloi S, Fredenberg E (2017) Breast-density measurement using photon-counting spectral mammography. Med Phys 44(7):3579–3593. https://doi.org/10.1002/mp.12279 CrossRefPubMed

17.

Browne JL, Casas L, Santandreu G, Rodriguez I, Navarro B, Tresserra F, Pascual MA (2020) Breast density measured volumetrically in a clinical environment: cross-sectional study with photon counting technology. Breast Cancer Res Treat 179(3):755–762. https://doi.org/10.1007/s10549-019-05502-7 CrossRefPubMed

18.

Hovhannisyan G, Chow L, Schlosser A, Yaffe MJ, Boyd NF, Martin LJ (2009) Differences in measured mammographic density in the menstrual cycle. Cancer Epidemiol Biomark Prev 18(7):1993–1999. https://doi.org/10.1158/1055-9965.EPI-09-0074 CrossRef

19.

Potten CS, Watson RJ, Williams GT, Tickle S, Roberts SA, Harris M, Howell A (1988) The effect of age and menstrual cycle upon proliferative activity of the normal human breast. Br J Cancer 58(2):163–170. https://doi.org/10.1038/bjc.1988.185 CrossRefPubMedPubMedCentral

20.

Ramakrishnan R, Khan SA, Badve S (2002) Morphological changes in breast tissue with menstrual cycle. Mod Pathol 15(12):1348–1356. https://doi.org/10.1097/01.MP.0000039566.20817.46 CrossRefPubMed

21.

Chan S, Su MYL, Lei FJ, Wu JP, Lin M, Nalcioglu O, …, Chen JH (2011) Menstrual cycle-related fluctuations in breast density measured by using three dimensional MR imaging. Radiology 261(3):744–751. https://doi.org/10.1148/radiol.11110506 CrossRefPubMedPubMedCentral

22.

Morrow M, Chatterton RT, Rademaker AW, Hou N, Jordan VC, Hendrick RE, Khan SA (2010) A prospective study of variability in mammographic density during the menstrual cycle. Breast Cancer Res Treat 121(3):565–574. https://doi.org/10.1007/s10549-009-0496-9 CrossRefPubMed

23.

Buist DSM, Aiello EJ, Miglioretti DL, White E (2006) Mammographic breast density, dense area, and breast area differences by phase in the menstrual cycle. Cancer Epidemiol Biomark Prev 15(11):2303–2306. https://doi.org/10.1158/1055-9965.EPI-06-0475 CrossRef

24.

Fowler PA, Casey CE, Cameron GG, Foster MA, Knight CH (1990) Cyclic changes in composition and volume of the breast during the menstrual cycle, measured by magnetic resonance imaging. BJOG 97(7):595–602. https://doi.org/10.1111/j.1471-0528.1990.tb02546.x CrossRef

25.

Wegienka G, Baird DD (2005) A comparison of recalled date of last menstrual period with prospectively recorded dates. J Women's Health 14(3):248–252. https://doi.org/10.1089/jwh.2005.14.248 CrossRef

Title: “Are changes in breast density during the menstrual cycle relevant? To what?”
Authors: Jean L. Browne
Natalie Korsun
Lilian Casas
Ignacio Rodriguez
Beatriz Valero
Andreina Rincon
M. Angela Pascual
Publication date: 01-09-2020
Publisher: Springer US
Keywords: Mammography
Mammography
Published in: Breast Cancer Research and Treatment / Issue 2/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05788-y

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