Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Department of Breast Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, China.
Cancer Prev Res (Phila). 2020 May;13(5):475-482. doi: 10.1158/1940-6207.CAPR-19-0549. Epub 2020 Feb 26.
Mammographic breast density is a strong risk factor for breast cancer. We comprehensively investigated the associations of body mass index (BMI) change from ages 10, 18, and 30 to age at mammogram with mammographic breast density in postmenopausal women. We used multivariable linear regression models, adjusted for confounders, to investigate the associations of BMI change with volumetric percent density, dense volume, and nondense volume, assessed using Volpara in 367 women. At the time of mammogram, the mean age was 57.9 years. Compared with women who had a BMI gain of 0.1-5 kg/m from age 10, women who had a BMI gain of 5.1-10 kg/m had a 24.4% decrease [95% confidence interval (CI), 6.0%-39.2%] in volumetric percent density; women who had a BMI gain of 10.1-15 kg/m had a 46.1% decrease (95% CI, 33.0%-56.7%) in volumetric percent density; and women who had a BMI gain of >15 kg/m had a 56.5% decrease (95% CI, 46.0%-65.0%) in volumetric percent density. Similar, but slightly attenuated associations were observed for BMI gain from ages 18 and 30 to age at mammogram and volumetric percent density. BMI gain over the life course was positively associated with nondense volume, but not dense volume. We observed strong associations between BMI change over the life course and mammographic breast density. The inverse associations between early-life adiposity change and volumetric percent density suggest that childhood adiposity may confer long-term protection against postmenopausal breast cancer via its effect of mammographic breast density.
乳房 X 光摄影术乳房密度是乳腺癌的一个重要危险因素。我们综合研究了从 10 岁、18 岁和 30 岁到乳房 X 光摄影术时的体重指数(BMI)变化与绝经后妇女乳房 X 光摄影术乳房密度的关系。我们使用多变量线性回归模型,调整了混杂因素,来研究 BMI 变化与使用 Volpara 评估的体积百分比密度、致密体积和非致密体积之间的关系,共纳入了 367 名女性。在进行乳房 X 光摄影术时,平均年龄为 57.9 岁。与从 10 岁开始 BMI 增加 0.1-5kg/m 的女性相比,BMI 增加 5.1-10kg/m 的女性其体积百分比密度降低了 24.4%(95%可信区间,6.0%-39.2%);BMI 增加 10.1-15kg/m 的女性其体积百分比密度降低了 46.1%(95%可信区间,33.0%-56.7%);BMI 增加>15kg/m 的女性其体积百分比密度降低了 56.5%(95%可信区间,46.0%-65.0%)。从 18 岁和 30 岁到乳房 X 光摄影术时 BMI 增加与体积百分比密度之间也观察到了类似但略有减弱的关系。一生中 BMI 的增加与非致密体积呈正相关,但与致密体积无关。我们发现一生中 BMI 的变化与乳房 X 光摄影术乳房密度之间存在很强的关联。早期肥胖变化与体积百分比密度之间的负相关表明,儿童时期肥胖可能通过对乳房 X 光摄影术乳房密度的影响,对绝经后乳腺癌提供长期保护。