Bigham Zahna, Holder Etienne X, Rodday Angie Mae, Breeze Janis L, Nelson Kerrie P, Palmer Julie R, Freund Karen M, Bertrand Kimberly A
Tufts University Graduate School of Biomedical Sciences, Boston, Massachusetts.
Tufts University School of Medicine, Boston, Massachusetts.
Cancer Epidemiol Biomarkers Prev. 2024 Dec 2;33(12):1640-1650. doi: 10.1158/1055-9965.EPI-24-0494.
High mammographic density is one of the strongest breast cancer risk factors; however, determinants of high mammographic density are understudied in Black women. We assessed growth and development factors across the lifecourse in relation to mammographic density.
Within the Black Women's Health Study, we used Cumulus software to assess percent mammographic density from digital screening mammograms for 5,905 women ages 40 to 74 years. We fit linear regression models to quantify the association of lifecourse characteristics including birthweight, childhood somatotype, age at menarche, body mass index (BMI) at age 18 years, height, BMI at mammography, and adulthood waist-to-hip ratio with density overall and by age. We also performed a path analysis to assess the total and mediating effects of the growth and development factors on density.
BMI at age 18 years, height, BMI at mammography, and waist-to-hip ratio were significantly and inversely associated with density. On path analysis, total effects of childhood somatotype (standardized β = -0.05, P < 0.001), BMI at age 18 years (standardized β = -0.13, P < 0.001), BMI at mammography (standardized β = -0.22, P < 0.001), and waist-to-hip ratio (standardized β = -0.04, P < 0.001) were associated with density.
Several factors across the lifecourse-greater childhood somatotype, BMI at age 18 years, height, BMI at mammography, and waist-to-hip ratio-were associated with lower mammographic density in this cohort of Black women.
Body size closer to the time of mammography may be more meaningful in determining mammographic density, though early-life adiposity also influences mammographic density. See related In the Spotlight, p. 1541.
乳腺钼靶密度高是最强的乳腺癌风险因素之一；然而，关于黑人女性乳腺钼靶密度高的决定因素的研究较少。我们评估了一生中与乳腺钼靶密度相关的生长发育因素。
在黑人女性健康研究中，我们使用积云软件从5905名年龄在40至74岁的女性的数字化筛查乳腺钼靶片中评估乳腺钼靶密度百分比。我们拟合线性回归模型，以量化包括出生体重、儿童体型、初潮年龄、18岁时的体重指数（BMI）、身高、钼靶检查时的BMI以及成年时的腰臀比等生命历程特征与总体密度及按年龄划分的密度之间的关联。我们还进行了路径分析，以评估生长发育因素对密度的总体和中介效应。
18岁时的BMI、身高、钼靶检查时的BMI以及腰臀比与密度显著负相关。在路径分析中，儿童体型（标准化β = -0.05，P < 0.001）、18岁时的BMI（标准化β = -0.13，P < 0.001）、钼靶检查时的BMI（标准化β = -0.22，P < 0.001）和腰臀比（标准化β = -0.04，P < 0.001）的总体效应与密度相关。
在这一队列的黑人女性中，一生中的几个因素——更大的儿童体型、18岁时的BMI、身高、钼靶检查时的BMI以及腰臀比——与较低的乳腺钼靶密度相关。
在确定乳腺钼靶密度时，接近钼靶检查时间的体型可能更有意义，尽管早期肥胖也会影响乳腺钼靶密度。见相关的《聚焦》，第1541页。
