scholarly journals Mammographic microcalcifications and risk of breast cancer

Author(s):  
Shadi Azam ◽  
Mikael Eriksson ◽  
Arvid Sjölander ◽  
Marike Gabrielson ◽  
Roxanna Hellgren ◽  
...  

Abstract Background Mammographic microcalcifications are considered early signs of breast cancer (BC). We examined the association between microcalcification clusters and the risk of overall and subtype-specific BC. Furthermore, we studied how mammographic density (MD) influences the association between microcalcification clusters and BC risk. Methods We used a prospective cohort (n = 53,273) of Swedish women with comprehensive information on BC risk factors and mammograms. The total number of microcalcification clusters and MD were measured using a computer-aided detection system and the STRATUS method, respectively. Cox regressions and logistic regressions were used to analyse the data. Results Overall, 676 women were diagnosed with BC. Women with ≥3 microcalcification clusters had a hazard ratio [HR] of 2.17 (95% confidence interval [CI] = 1.57–3.01) compared to women with no clusters. The estimated risk was more pronounced in premenopausal women (HR = 2.93; 95% CI = 1.67–5.16). For postmenopausal women, microcalcification clusters and MD had a similar influence on BC risk. No interaction was observed between microcalcification clusters and MD. Microcalcification clusters were significantly associated with in situ breast cancer (odds ratio: 2.03; 95% CI = 1.13–3.63). Conclusions Microcalcification clusters are an independent risk factor for BC, with a higher estimated risk in premenopausal women. In postmenopausal women, microcalcification clusters have a similar association with BC as baseline MD.

1995 ◽  
Vol 13 (2) ◽  
pp. 513-529 ◽  
Author(s):  
I A Jaiyesimi ◽  
A U Buzdar ◽  
D A Decker ◽  
G N Hortobagyi

PURPOSE The mechanisms of antitumor activity, clinical pharmacology, toxicity, and efficacy of tamoxifen in women with early and advanced breast cancer and the drug's potential role in prevention of breast cancer were reviewed. DESIGN A comprehensive review of the literature from 1966 to 1994 was conducted; reports were identified using the Cancerline and Medline data bases. RESULTS The cellular actions of tamoxifen are not completely understood, but it appears that the drug's antiproliferative effects are mediated primarily by inhibition of the activities of estrogen through binding to estrogen receptors (ERs). Disease-free and overall survival rates have been increased in postmenopausal women with ER-positive tumors when tamoxifen has been used as adjuvant therapy (irrespective of nodal status). In premenopausal women, adjuvant therapy with tamoxifen has been associated with prolongation of disease-free survival, but its impact on survival remains to be defined. Tamoxifen is the initial hormonal treatment of choice in both premenopausal and postmenopausal women with ER-positive metastatic disease. Retrospective review of adjuvant therapy studies showed an approximately 39% reduction in the incidence of contralateral primary breast carcinoma in tamoxifen-treated women, which indicates that tamoxifen could have a role in breast cancer prevention. CONCLUSION The use of tamoxifen has resulted in a substantial modification of breast cancer's natural history, particularly in postmenopausal women. Ongoing clinical trials will examine the effects of tamoxifen therapy on lipids, coagulation proteins, bone, and endometrium, and its effectiveness as an agent in the prevention of breast cancer.


2000 ◽  
Vol 3 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Satu Männistö ◽  
Mikko Virtanen ◽  
Vesa Kataja ◽  
Matti Uusitupa ◽  
Pirjo Pietinen

AbstractObjectiveTo study the association between lifetime alcohol consumption and the risk of breast cancer.Design and settingA case–control study carried out in eastern Finland. Information about alcohol consumption was obtained by two methods: a self-administered food frequency questionnaire (FFQ) including alcohol consumption during the previous 12 months, and a lifetime alcohol consumption questionnaire (AQ) which was administered by the study nurse.SubjectsThe study consisted of 301 breast cancer cases (25–75 years old) and 443 population controls.ResultsThe subjects reported higher current alcohol consumption in the AQ compared to the FFQ. According to the AQ, premenopausal cases consumed on average 28 g and controls 24 g alcohol week−1; in postmenopausal women the values were 15 and 14 g, respectively. About 30% of premenopausal and 60% of postmenopausal women were classified as non-drinkers. The correlation for current alcohol consumption between the FFQ and the AQ was 0.80 in premenopausal women but only 0.40 in postmenopausal women. Current alcohol consumption seemed to influence the reporting of total lifetime alcohol consumption. Current alcohol consumption was not associated with the risk of breast cancer either in premenopausal or postmenopausal women; neither were associations found between alcohol consumption at age of first use, use before the age of 30, or total lifetime alcohol consumption and the risk of breast cancer.ConclusionsOn average, one to three drinks per week did not increase the risk of breast cancer in this study. Consumption levels were, however, too low to exclude increased risk with high regular consumption. Further research is necessary on lifetime alcohol consumption.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 352-352
Author(s):  
Rawiwan Sirirat ◽  
Yessenia Tantamango-Bartley ◽  
Celine Heskey ◽  
Ella Haddad ◽  
Gary Fraser ◽  
...  

Abstract Objectives Breast cancer is the most diagnosed form of cancer among American women. Worldwide, it is second only to lung cancer. Phytosterols are phytochemicals found in plant foods that have potential benefits for breast cancer. Research on phytosterols and cancer associations to date has been limited to breast cancer cell lines and animal studies, and the results have been promising. Our objective is to examine the association between breast cancer incidence and phytosterol intake in the Adventist Health Study-2, a large cohort in North America. Methods The present study estimated the association between phytosterol intake and breast cancer incidence in 52,734 females who were part of the Adventist Health Study 2 (AHS-2) cohort. Breast cancer cases (n = 1050) were ascertained with tumor registries from 2008 to 2014. Phytosterols content in foods was quantified by using USDA 17 and other published sources. These values were used to estimate phytosterol intake from food intake assessed by a self-administered food frequency questionnaires (FFQ). Results Hazard ratios were below the null, but statistically non-significant for β-sitosterol [HR = 0.77, 95%CI (0.44–1.36)], campesterol [HR = 0.84, 95%CI (0.46–1.55)], stigmasterol [HR = 0.76 (0.46–1.26)], and total phytosterol [HR = 0.77, 95%CI (0.43–1.40)]. In premenopausal women, HRs ranged between 0.95–1.72; in postmenopausal women, HRs were below the null, ranging between 0.67–0.83. In both premenopausal and postmenopausal women, HRs were statistically non-significant. Conclusions The inverse association between phytosterol consumption and breast cancer incidence appears uncertain. The uncertainty possibly could be due to lack of power or measurement error. Additional epidemiological studies with a larger number of breast cancer cases, improved phytosterol intake estimates, or both are needed. Funding Sources Unilever Research &Development, Vlaardingen, The Netherlands.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18210-e18210
Author(s):  
John Khoury ◽  
Sruthi Jinna ◽  
Ali Sahlieh ◽  
Rebecca Chacko ◽  
David Macari ◽  
...  

e18210 Background: Although many studies have investigated the association of blood 25OH-vitamin D (vit-D) levels with breast cancer prognosis, the results have been mixed. It has been suggested that low vit-D concentrations were associated with advanced tumor stage and triple-negative (TNBC) subtype. We retrospectively investigated associations of serum vit-D levels with triple negative breast cancer outcome. Methods: Out of 797 cases of TNBC diagnosed at William Beaumont Hospital between 2006-2017, 163 patients had vit-D level available within 1 year prior to diagnosis. Analyses of vit-D levels was classified by 3 cut points (deficient, < 20.0 ng/mL; insufficient, 20.0-29.9 ng/mL; sufficient, ≥30.0 ng/mL). Primary outcomes are disease free survival (DFS) and overall survival (OS). SPSS statistics 25 software was used to analyze the data. Results: Median age of diagnosis of TNBC was 60. Of these patients 43.6% were diagnosed with stage I, 37.4% at stage II, 4.9% at stage III and 4.9% at stage IV. 47.2% of the patients had sufficient vit-D level prior to diagnosis, 28.2% with insufficient vit-D level and 24.5% with deficient vit-D. Vit-D deficiency was more prevalent in premenopausal than in postmenopausal women (33.3%, 41% and 25.6% in premenopausal women for deficient, insufficient and sufficient levels respectively vs 21.8%, 24.2% and 54% in postmenopausal women). Rates of Vit-D deficiency were not different between early disease and advanced disease (24.3% of patient with stage I-II vs 25% in patients with stage III-IV). Median OS and disease-free survival were not statistically different among the 3 different categories. 5-year OS was 91%, 91% and 85% for deficient, insufficient and sufficient levels respectively. 5-year DFS was 93%, 95% and 95% for deficient, insufficient and sufficient levels respectively. Multivariate COX regression analysis demonstrated that age and stage were associated with mortality, whereas vit-D level was not. Conclusions: The results from this study show that adequate vit-D level do not have an impact on OS and DFS in patients with triple negative breast cancer. Premenopausal women are more likely to have inadequate vit-D level. Identification and treatment of vitamin D deficiency is still important for musculoskeletal health and possibly extraskeletal health in general population and breast cancer survivors specifically.


2012 ◽  
Vol 03 (06) ◽  
pp. 1020-1028 ◽  
Author(s):  
Edén A. Alanís-Reyes ◽  
José L. Hernández-Cruz ◽  
Jesús S. Cepeda ◽  
Camila Castro ◽  
Hugo Terashima-Marín ◽  
...  

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Bahareh Sasanfar ◽  
Fatemeh Toorang ◽  
Ahmad Esmaillzadeh ◽  
Kazem Zendehdel

Abstract Background Previous studies on the link between macronutrients and breast cancer have mostly focused on individual macronutrients rather than their combination. This study investigates the association between adherence to a low carbohydrate diet and odds of breast cancer among women. Methods This hospital-based case-control study was carried out on 412 women with pathologically confirmed breast cancer within the past year and 456 apparently healthy controls that were matched in terms of age and residential place. Dietary data was collected using a 168-item validated FFQ. Participants were classified in terms of quintiles of percentages of energy intake from carbohydrates, proteins, and fats. Then, individuals in the highest quintile of fat and protein intake were given a score of 5 and those in the lowest quintile of these macronutrients were given a score of 1. Participants in the other quintiles of these macronutrients were given the corresponding score. In terms of carbohydrate intake, those in the highest quintile received a score of 1 and those in the lowest quintile received 5. The scores were then summed up to calculate the total low carbohydrate diet (LCD) score, which varied from 3 to 15. A higher score meant greater adherence to a low carbohydrate diet. Results The mean age of study participants was 45.2 y and mean BMI was 28.4 kg/m2. Mean LCD score of participants was 8.9 ± 2.5 (8.9 ± 2.6 in cases and 9.0 ± 2.5 in controls). Although no significant association was observed between adherence to the LCD score and odds of breast cancer in the study population, a trend toward significant positive association was seen between consumption of LCD and odds of breast cancer in postmenopausal women; after controlling for several potential confounders, individuals in the third quartile of LCD score were 1.94 times more likely to have breast cancer than those in the lowest quartile (95% CI: 1.00, 3.76). This association strengthened after controlling for dietary variables (2.50; 1.18–5.32). Even after further adjustment for BMI, this association remained significant (2.64, 1.23–5.67). No significant relationship was observed in premenopausal women, either before or after controlling for confounders. Conclusion Adherence to LCD may be associated with increased odds of breast cancer in postmenopausal women. Prospective cohort studies are needed to confirm these findings.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1532-1532
Author(s):  
A. P. O'Dea ◽  
M. Thirunavu ◽  
J. Nydegger ◽  
J. R. Klemp ◽  
B. F. Kimler ◽  
...  

1532 Background: Tamoxifen when used in the high estrogen milieu of premenopausal women may reduce bone density. However, the proportion of premenopausal women at increased risk for breast cancer who have low bone density and are likely to take tamoxifen is unknown. Methods: Premenopausal women attending a high-risk clinic were invited to take part in an ongoing prospective study assessing bone mineral density (BMD) loss. Women on bisphosphonates or those previously treated with selective estrogen receptor modulators were excluded. BMD was measured by DEXA, serum 25-hydroxyvitamin D (25OHD) by chemiluminescence, and information on risk factors for osteoporosis and breast cancer was obtained by questionnaire. Results: 106 premenopausal women were entered between April and October 2008. Median age was 42 (range 23–57), median body mass index (BMI) was 25 kg/m2 (range 15–44). All but two were Caucasian. 13% had a prior biopsy with atypical hyperplasia (AH) or in situ carcinoma, 36% had a family history of osteoporosis, 56% took calcium supplements, and 47% took vitamin D supplements. Median sun exposure was 480 minutes per month, the majority with sunscreen. Median serum 25OHD was 34 ng/ml. Five had deficiency (< 20 ng/mL), and 45 women deficiency or insufficiency (< 32 ng/mL). Seven subjects ages 31 to 48 had evidence of low BMD (T-score of less than -1.0 in the spine or hip.) One woman with low BMD by DEXA had a 25OHD level < 32 ng/ml. Women with low BMD had lower BMIs (median of 22 vs. 25 kg/m2, p = 0.020) than women with normal bone density. There was no difference in history of vitamin D and calcium supplement use, and low 25OHD levels did not explain the low T-scores. Information on vitamin D receptor polymorphisms associated with BMD loss is pending. Importantly, 21% of women with a prior biopsy demonstrating AH or in situ carcinoma had evidence of bone density loss compared to 4% of women without such a biopsy (p = 0.048). Conclusions: Premenopausal women with a history of AH or in situ carcinoma are most likely to take tamoxifen for primary prevention and in our ongoing study have a high enough incidence of low bone density to make baseline assessment by DEXA a consideration, particularly for those with predisposing factors such as low BMI and lack of sun exposure. No significant financial relationships to disclose.


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