Holder Etienne X, Bigham Zahna, Nelson Kerrie P, Barnard Mollie E, Palmer Julie R, Bertrand Kimberly A
Slone Epidemiology Center at Boston University, Boston, Massachusetts, USA.
Tufts University Graduate School of Biomedical Sciences, Boston, Massachusetts, USA.
Int J Cancer. 2025 Mar 15;156(6):1173-1180. doi: 10.1002/ijc.35223. Epub 2024 Oct 19.
High mammographic density is a well-established risk factor for breast cancer; however, data from Black women are limited. It is largely unknown how mammographic density is associated with breast cancer subtypes among Black women. We examined the association between percent mammographic density (PMD) and breast cancer risk among participants in the Black Women's Health Study. Digital screening mammograms were available for 363 cases and 5541 non-cases. Cumulus software was used to assess PMD. We used inverse probability of sampling weights and Cox proportional hazards models, adjusted for age and body mass index, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) overall and by age at mammography and estrogen receptor (ER) status of the breast tumors. Multivariable models included additional breast cancer risk factors. Tests of statistical significance were 2-sided. In simple models, women in the highest quartile of PMD had 53% increased odds of breast cancer compared to those in the lowest quartile (HR 1.53; 95% CI: 1.11, 2.11). HRs were 1.37 (95% CI: 0.83, 2.24) among women <55 years of age and 1.68 (95% CI: 1.10, 2.56) among women aged ≥55 years. HRs were 1.49 (95% CI: 1.02, 2.16) for ER+ cancer and 1.45 (95% CI: 0.73, 2.87) for ER- cancer. Associations were largely unchanged in multivariable models. In this study of U.S. Black women, higher PMD was associated with ER+ and ER- breast cancer risk. Findings from this study reinforce the importance of breast density as a risk factor for breast cancer in Black women.
乳腺钼靶高密度是公认的乳腺癌风险因素；然而，黑人女性的数据有限。在很大程度上，尚不清楚乳腺钼靶密度与黑人女性乳腺癌亚型之间的关联。我们在黑人女性健康研究的参与者中，研究了乳腺钼靶密度百分比（PMD）与乳腺癌风险之间的关联。有363例病例和5541例非病例的数字化筛查乳腺钼靶图像可用。使用积云软件评估PMD。我们采用抽样权重的逆概率和Cox比例风险模型，对年龄和体重指数进行了调整，以估计总体以及按乳腺钼靶检查时的年龄和乳腺肿瘤雌激素受体（ER）状态分层的风险比（HRs）和95%置信区间（CIs）。多变量模型纳入了其他乳腺癌风险因素。显著性检验为双侧检验。在简单模型中，与处于最低四分位数的女性相比，PMD处于最高四分位数的女性患乳腺癌的几率增加了53%（HR 1.53；95% CI：1.11，2.11）。年龄<55岁的女性HR为1.37（95% CI：0.83，2.24），年龄≥55岁的女性HR为1.68（95% CI：1.10，2.56）。ER阳性癌症的HR为1.49（95% CI：1.02，2.16），ER阴性癌症的HR为
