The relationship between breast density change during menopause and the risk of breast cancer in Korean women

2021 ◽  
pp. canprevres.0542.2021
Author(s):  
Danbee Kang ◽  
Ji-Yeon Kim ◽  
Ji-Young Kim ◽  
Han Song Mun ◽  
Sook Ja Yoon ◽  
...  
2021 ◽  
Author(s):  
Eunji Choi ◽  
Mina Suh ◽  
So-Youn Jung ◽  
Kyu-Won Jung ◽  
Sohee Park ◽  
...  

Abstract Background: High breast cancer incidence among women in forties are specific to Asian, implicating dense breast. This study examined the natural history of breast cancer progression among Korean women according to the levels of breast density.Methods: We applied a three-state Markov model to fit the natural history of breast cancer to data in the Korean National Cancer Screening Program. Diagnosis of breast cancer was ascertained by linkage to the Korean Central Cancer Registry. Disease progression rates (i.e., transition rates from healthy to preclinical state, and from preclinical to clinical state) were estimated across levels of breast density determined by the Breast Imaging, Reporting and Data System (BI-RADS). Preclinical incidence of breast cancer, mean sojourn time (MST) and mammographic screening sensitivity were simultaneously generated in the model.Results: Overall prevalence of dense breast among Korean women was 53.9%, which declined with age. Transition rate from healthy to preclinical state, indicating the preclinical incidence of breast cancer, was estimated to be higher among women aged 40-49 years (0.0019, 95% CI; 0.0017-0.0021) and women aged 50-59 years (0.0020, 95% CI; 0.0017-0.0022), than older women aged 60-69 years (0.0014, 95% CI; 0.0012-0.0017). Transition rate from preclinical to clinical state was also fastest among younger age groups, which directly translated to the shortest MSTs, estimated as 1.98 (95% CI; 1.67-2.33), 2.49 (95% CI; 1.92-3.22) and 3.07 (95% CI; 2.11-4.46) years for women in forties, fifties and sixties, respectively. The sensitivity of the mammographic screening was higher among older women (0.70, 95% CI; 0.62-0.77) than women in fifties (0.65, 95% CI; 0.62-0.77) and women in forties (0.61, 95% CI; 0.54-0.61). Having dense breasts increased the likelihood of the preclinical cancer risk (1.96 to 2.35 times) and decreased the duration of MST (1.53 to 2.02 times).Conclusions: Korean women showed 1.5 to 2 times higher prevalence of dense breast tissues, compared to Western women. This study estimated Korean-specific parameters for the natural history of breast cancer that would be utilized for establishing optimal screening strategies in countries with higher dense breast prevalence.


2015 ◽  
Vol 39 (6) ◽  
pp. 987-992 ◽  
Author(s):  
Marissa Albert ◽  
Freya Schnabel ◽  
Jennifer Chun ◽  
Shira Schwartz ◽  
Jiyon Lee ◽  
...  

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11584-e11584
Author(s):  
In Hae Park ◽  
Kyungran Ko ◽  
Ji Soo Choi ◽  
So-youn Jung ◽  
Seeyoun Lee ◽  
...  

e11584 Background: In Asian population, the peak incidence of breast cancer is women in their late forties. We investigated the association between volumetric breast density and breast cancer risk according to menstruation status and breast cancer subtypes in Korean women. Methods: We prospectively enrolled 509 newly diagnosed breast cancer patients and 1336 healthy control subjects who performed mammography at the National Cancer Center in Korea between Sep 2011 and Nov 2012. Breast density was estimated using volumetric breast composition measurement (VolparaTM). We collected clinical data including menstruation status, parity, BMI and use of postmenopausal hormones. For cancer patient, we additionally acquired following pathologic data: histologic type, tumor size and grade, receptor status, Ki-67, and nodal status. Results: Of a total of subjects, 1064 (57.7%) women were postmenopausal status. The risk of breast cancer increased progressively with increase in volumetric breast density (Ptrend <0.001) in all subjects. In addition, breast cancer risk increased in women < 60 years old (odds radio (OR) = 1.81), higher body mass index (BMI) (< 25kg/m2 vs. ≥ 25kg/m2) (OR = 2.41), and fewer childbirth (0/1 vs. ≥ 2) (OR=2.38). In postmenopausal women, higher breast density (category 4) showed a 3.00-fold (OR = 3.00, 95% confidence interval (CI) = 1.75-5.16, P<0.001) increased risk of breast cancer compared with lower breast density (category 1-2). In contrast, there was no such association in premenopausal women. The associations of volumetric breast density were stronger for HER2 positivity (Ptrend <0.019), and high Ki-67 (Ptrend <0.006) in postmenopausal breast cancer patients. There was a statistically significant association between lower breast density and hormone receptor (HR) positive/HER2 negative breast cancer (Ptrend <0.019). Conclusions: High volumetric breast density is associated with the risk of breast cancer having more aggressive tumor characteristics in postmenopausal women.


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