Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
Department of Health Sciences, Hanyang University College of Medicine, Seoul, Republic of Korea.
Int J Cancer. 2022 Sep 15;151(6):869-877. doi: 10.1002/ijc.34038. Epub 2022 May 11.
Mammographic breast density and body mass index (BMI) are strong risk factors of breast cancer, but few studies have investigated these factors in older women. Our study assessed the association between breast density, BMI and the breast cancer risk among women aged ≥75 years. We included women who underwent breast cancer screening between 2009 and 2014 and were followed up until 2020. Breast density was measured using Breast Imaging Reporting and Data System. BMI was classified into three groups: <23, 23 to <25 and ≥25. Cox proportional hazards models were used to estimate the association of breast density and BMI with breast cancer risk. In 483 564 women, 1885 developed breast cancer. The 5-year incidence increased with an increase in breast density and BMI. Increase in breast density was associated with an increased breast cancer risk in all BMI categories: among women with BMI <23, those with heterogeneous/extreme density had a 2.98-fold (95% CI: 2.23-3.80) increased risk of breast cancer compared to those with entirely fatty breasts. An increase in BMI was associated with increased breast cancer risk in women with the same breast density in all density categories. When the combined associations of breast density and BMI on the risk of breast cancer were considered, women with a BMI ≥25 and heterogeneous/extreme breast density had a 5.35-fold (95% CI: 4.26-6.72) increased risk of breast cancer compared to women with a BMI <23 and fatty breasts. Women aged ≥75 years, with dense breasts, regardless of BMI status, might benefit from a tailored screening strategy for early detection of breast cancer.
乳腺密度和体重指数（BMI）是乳腺癌的强烈危险因素，但很少有研究调查老年女性的这些因素。我们的研究评估了乳腺密度、BMI 与≥75 岁女性乳腺癌风险之间的关系。我们纳入了 2009 年至 2014 年期间接受乳腺癌筛查并随访至 2020 年的女性。使用乳腺影像报告和数据系统（BI-RADS）来测量乳腺密度。BMI 分为三组：<23、23-<25 和≥25。使用 Cox 比例风险模型来估计乳腺密度和 BMI 与乳腺癌风险的关系。在 483564 名女性中，1885 人患有乳腺癌。5 年发病率随乳腺密度和 BMI 的增加而增加。乳腺密度的增加与所有 BMI 类别中的乳腺癌风险增加相关：在 BMI<23 的女性中，与脂肪性乳房相比，异质性/极度致密乳房的乳腺癌风险增加 2.98 倍（95%CI：2.23-3.80）。BMI 的增加与所有密度类别的相同乳腺密度的女性的乳腺癌风险增加相关。当考虑乳腺密度和 BMI 对乳腺癌风险的联合关联时，BMI≥25 和异质性/极度致密乳腺的女性乳腺癌风险比 BMI<23 和脂肪性乳房的女性增加 5.35 倍（95%CI：4.26-6.72）。≥75 岁、乳腺致密、无论 BMI 状态如何的女性可能受益于针对乳腺癌早期检测的定制筛查策略。
