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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2010

01-10-2010 | American Society of Breast Surgeons

Impact of Breast Density on the Presenting Features of Malignancy

Authors: Nimmi Arora, MD, Tari A. King, MD, Lindsay M. Jacks, MS, Michelle M. Stempel, MPH, Sujata Patil, PhD, Elizabeth Morris, MD, Monica Morrow, MD

Published in: Annals of Surgical Oncology | Special Issue 3/2010

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Abstract

Purpose

To determine the relationship between breast density, presenting features and molecular subtype of cancer, and surgical treatment received.

Methods

Retrospective review of a prospectively maintained database. Eligible patients had stage 1–3 cancer, were treated between 1/2005 and 6/2007, and had estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) measurements and films available for review. Density was classified at presentation as 1–4 using the Breast Imaging Reporting and Data System (BI-RADS) classification.

Results

1,323 patients were included. Significant differences across the four density groups were present in age, race, multicentricity/focality, and presence of an extensive intraductal component (EIC). When density was combined into two groups, after adjustment for age, only an EIC and mammographically occult cancer were significantly more common in the dense groups. Extremely dense breasts (BI-RADS density 4) more commonly had luminal A tumors (p = 0.05), lobular cancers (p = 0.03), multicentricity (p = 0.02), and occult tumors (p < 0.0001). Greater density was associated with increased mastectomy use, with 61% of the extremely dense group having mastectomy versus 43% of those of lesser density (p = 0.01).

Conclusions

Cancers in extremely dense breasts occur in younger women, are more often mammographically occult, and appear to be phenotypically different from those arising in other density groups. The more common use of mastectomy may be related to these features, although density itself is not a selection criterion for mastectomy.
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Metadata
Title
Impact of Breast Density on the Presenting Features of Malignancy
Authors
Nimmi Arora, MD
Tari A. King, MD
Lindsay M. Jacks, MS
Michelle M. Stempel, MPH
Sujata Patil, PhD
Elizabeth Morris, MD
Monica Morrow, MD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1237-3

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