Breast Cancer Risk by Breast Density, Menopause, and Postmenopausal Hormone Therapy Use

被引:162
作者
Kerlikowske, Karla [1 ]
Cook, Andrea J.
Buist, Diana S. M.
Cummings, Steve R.
Vachon, Celine
Vacek, Pamela
Miglioretti, Diana L.
机构
[1] Univ Calif San Francisco, Gen Internal Med Sect, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA
关键词
MAMMOGRAPHIC DENSITY; PARENCHYMAL PATTERNS; REPLACEMENT THERAPY; UNITED-STATES; ASSOCIATION; WOMEN; AGE; PROGESTIN; ESTROGEN; SURVIVAL;
D O I
10.1200/JCO.2009.26.4770
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose 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. Methods 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/m(2). Odds of advanced (ie, IIb, III, IV) versus early (ie, I, IIa) stage invasive cancer was calculated according to BIRADS density. Results 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). Conclusion 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.
引用
收藏
页码:3830 / 3837
页数:8
相关论文
共 38 条
[1]   Association between mammographic breast density and breast cancer tumor characteristics [J].
Aiello, EJ ;
Buist, DSM ;
Emily, W ;
Porter, PL .
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2005, 14 (03) :662-668
[2]  
*AM COLL OBST GYN, 1998, AM COLL OBST GYN ED, V247, P1
[3]  
[Anonymous], 2003, Breast imaging reporting and data system
[4]   Breast cancer surveillance consortium: A national mammography screening and outcomes database [J].
BallardBarbash, R ;
Taplin, SH ;
Yankaskas, BC ;
Ernster, VL ;
Rosenberg, RD ;
Carney, PA ;
Barlow, WE ;
Geller, BM ;
Kerlikowske, K ;
Edwards, BK ;
Lynch, CF ;
Urban, N ;
Key, CR ;
Poplack, SP ;
Worden, JK ;
Kessler, LG .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1997, 169 (04) :1001-1008
[5]   Heritability of mammographic density, a risk factor for breast cancer [J].
Boyd, NF ;
Dite, GS ;
Stone, J ;
Gunasekara, A ;
English, DR ;
McCredie, MRE ;
Giles, GG ;
Tritchler, D ;
Chiarelli, A ;
Yaffe, MJ ;
Hopper, JL .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (12) :886-894
[6]   QUANTITATIVE CLASSIFICATION OF MAMMOGRAPHIC DENSITIES AND BREAST-CANCER RISK - RESULTS FROM THE CANADIAN NATIONAL BREAST SCREENING STUDY [J].
BOYD, NF ;
BYNG, JW ;
JONG, RA ;
FISHELL, EK ;
LITTLE, LE ;
MILLER, AB ;
LOCKWOOD, GA ;
TRITCHLER, DL ;
YAFFE, MJ .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1995, 87 (09) :670-675
[7]   Mammographic density as a surrogate marker for the effects of hormone therapy on risk of breast cancer [J].
Boyd, Norman F. ;
Martin, Lisa J. ;
Li, Qing ;
Sun, Limei ;
Chiarelli, Anna M. ;
Hislop, Greg ;
Yaffe, Martin J. ;
Minkin, Salomon .
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2006, 15 (05) :961-966
[8]   MAMMOGRAPHIC FEATURES AND BREAST-CANCER RISK - EFFECTS WITH TIME, AGE, AND MENOPAUSE STATUS [J].
BYRNE, C ;
SCHAIRER, C ;
WOLFE, J ;
PAREKH, N ;
SALANE, M ;
BRINTON, LA ;
HOOVER, R ;
HAILE, R .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1995, 87 (21) :1622-1629
[9]   Influence of estrogen plus progestin on breast, cancer and mammography in healthy postmenopausal women - The Women's Health Initiative Randomized trial [J].
Chlebowski, RT ;
Hendrix, SL ;
Langer, RD ;
Stefanick, ML ;
Gass, M ;
Lane, D ;
Rodabough, RJ ;
Gilligan, MA ;
Cyr, MG ;
Thomson, CA ;
Khandekar, J ;
Petrovitch, H ;
McTiernan, A .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 289 (24) :3243-3253
[10]   Categorizing breast mammographic density: intra- and interobserver reproducibility of BI-RADS density categories [J].
Ciatto, S ;
Houssami, N ;
Apruzzese, A ;
Bassetti, E ;
Brancato, B ;
Carozzi, F ;
Catarzi, S ;
Lamberini, MP ;
Marcelli, G ;
Pellizzoni, R ;
Pesce, B ;
Risso, G ;
Russo, F ;
Scorsolini, A .
BREAST, 2005, 14 (04) :269-275