Genentech, South San Francisco, USA.
Mayo Clinic, Rochester, USA.
Breast Cancer Res Treat. 2019 Aug;177(1):165-173. doi: 10.1007/s10549-019-05283-z. Epub 2019 May 25.
Breast density and body mass index (BMI) are used for breast cancer risk stratification. We evaluate whether the positive association between volumetric breast density and breast cancer risk is strengthened with increasing BMI.
The San Francisco Mammography Registry and Mayo Clinic Rochester identified 781 premenopausal and 1850 postmenopausal women with breast cancer diagnosed between 2007 and 2015 that had a screening digital mammogram at least 6 months prior to diagnosis. Up to three controls (N = 3535) were matched per case on age, race, date, mammography machine, and state. Volumetric percent density (VPD) and dense volume (DV) were measured with Volpara™. Breast cancer risk was assessed with logistic regression stratified by menopause status. Multiplicative interaction tests assessed whether the association of density measures was differential by BMI categories.
The increased risk of breast cancer associated with VPD was strengthened with higher BMI for both premenopausal (p = 0.01) and postmenopausal (p = 0.0003) women. For BMI < 25, 25-30, and ≥ 30 kg/m, ORs for breast cancer for a 1 SD increase in VPD were 1.24, 1.65, and 1.97 for premenopausal, and 1.20, 1.55, and 2.25 for postmenopausal women, respectively. ORs for breast cancer for a 1 SD increase in DV were 1.39, 1.33, and 1.51 for premenopausal (p = 0.58), and 1.31, 1.34, and 1.65 (p = 0.03) for postmenopausal women for BMI < 25, 25-30 and ≥ 30 kg/m, respectively.
The effect of volumetric percent density on breast cancer risk is strongest in overweight and obese women. These associations have clinical relevance for informing prevention strategies.
乳房密度和体重指数（BMI）用于乳腺癌风险分层。我们评估了体积乳房密度与乳腺癌风险之间的正相关关系是否随着 BMI 的增加而增强。
旧金山乳腺摄影登记处和梅奥诊所罗切斯特分校在 2007 年至 2015 年间，确定了 781 名绝经前和 1850 名绝经后妇女，这些妇女在诊断前至少 6 个月接受了筛查数字乳房 X 光检查，且被诊断患有乳腺癌。每个病例匹配了最多三个对照（N=3535），匹配因素包括年龄、种族、日期、乳房 X 光机和州。使用 Volpara™测量体积百分比密度（VPD）和致密体积（DV）。使用逻辑回归按绝经状态分层评估乳腺癌风险。乘法交互检验评估密度测量值与 BMI 类别之间的关联是否存在差异。
VPD 与乳腺癌风险的相关性随着 BMI 的增加而增强，这在绝经前（p=0.01）和绝经后（p=0.0003）妇女中均成立。对于 BMI<25、25-30 和≥30kg/m，VPD 每增加 1 个标准差，绝经前妇女的乳腺癌比值比（OR）分别为 1.24、1.65 和 1.97，绝经后妇女的 OR 分别为 1.20、1.55 和 2.25。对于 DV，VPD 每增加 1 个标准差，绝经前妇女的 OR 分别为 1.39、1.33 和 1.51（p=0.58），绝经后妇女的 OR 分别为 1.31、1.34 和 1.65（p=0.03），BMI<25、25-30 和≥30kg/m。
体积百分比密度对乳腺癌风险的影响在超重和肥胖女性中最强。这些关联对告知预防策略具有临床意义。
