The DAMA - Diet Exercise and Mammography (Dieta Attività fisica e MAmmografia) Trial: a physical activity and diet intervention trial to reduce mammographic breast density, a strong risk factor for breast cancer, in postmenopausal women

Purpose Increased mammographic breast density is well recognized as a breast cancer risk factor in the general population. However, it is unclear whether it is a risk factor in women with BRCA mutations. We present the results of a nested case-control screening study investigating the relationship between breast density and breast cancer incidence in this population. Patients and Methods Women ages 25 to 65 years with known BRCA mutations were enrolled onto a single-center, high-risk breast cancer screening program. Using a computer-aided technique (Cumulus), quantitative percentage density (PD) was measured for each participant on her baseline mammogram by a single, blinded observer. Results Between November 1997 and March 2008, 462 women (mean age, 44 years; 245 BRCA1 and 217 BRCA2) were screened and 50 breast cancers were diagnosed (38 invasive, 12 ductal carcinoma in situ [DCIS]). Density was not measured in 40 women of whom four developed cancer (three invasive, one DCIS). Mean PD (± standard deviation [SD]) for 376 women who did not develop breast cancer was 34% (23) compared with 31% (21) for 46 women with cancer (P = .51). Logistic regression model of breast cancer incidence and PD revealed an odds ratio of 0.99 (± 0.01 SD) for a one-unit increase in PD (P = .44). Results remained nonsignificant in multivariate analysis, as well as when women with pure DCIS were excluded. Conclusion Increased mammographic breast density is not associated with higher breast cancer incidence in women with BRCA mutations. On the basis of these findings, density should not be considered a factor for these women in decision making regarding prophylactic surgery or chemoprevention.

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Quantitative analysis of breast parenchymal background enhancement (BPE) on magnetic resonance (MR) imaging: Association with mammographic breast density and aggressiveness of the primary cancer in postmenopausal women.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.26_suppl.38 ◽

2013 ◽

Vol 31 (26_suppl) ◽

pp. 38-38 ◽

Cited By ~ 2

Author(s):

Hye Shin Ahn ◽

Sun Mi Kim ◽

Mijung Jang ◽

Bo La Yun

Keyword(s):

Breast Cancer ◽

Quantitative Analysis ◽

Postmenopausal Women ◽

Breast Density ◽

Primary Breast Cancer ◽

Mammographic Breast Density ◽

Primary Cancer ◽

Systemic Recurrence ◽

Patient Consent ◽

The Mean

38 Background: To evaluate semiautomated quantitative analysis of the BPE in postmenopausal women who were diagnosed breast cancer and to correlate it with mammographic breast density and aggressiveness of the primary cancer. Methods: Informed patient consent was waived after institutional review board approved this study. Four hundred eighty two breast cancer patients performed breast MRI in our institution during 16 months, and 84 postmenopausal women of them were included in this study (median age, 67.2 years; range, 60-76 years). Ordinary values of BPE and breast density were described by an experienced breast radiologist using the BIRADS lexicon. The BPE was calculated with semiautomated quantitative method for quantitative analysis: BPE coefficient (BEC = SI1-SI0 / S0 × 100), where SI is signal intensity, SI1 is the SI enhancement measured in the largest dimension of the sagittal plane at the first postcontrast image, and S0 is the SI before contrast injection. On surgical pathology, pathologic subtype, nuclear and histologic grade, estrogen receptor (ER), progesterone receptor (PR), HER2≠neu, venous and lymphatic invasion, lymph node metastasis was evaluated. And then, the mean BEC of the patients who diagnosed local or systemic recurrence on follow-up was calculated and compared with that of the patients without recurrence. The statistical analysis was performed using Kruskal-Wallis test and Mann-Whitney U test. Results: The mean BEC of the postmenopausal women was 3.96 ± 6.71 in right breast and 3.41 ± 8.09 in left breast. There was no significant difference in the BEC between mammographic breast density groups (P > 0.05). There was no significant correlation between BPE and aggressiveness of the primary breast cancer. However, the mean BEC was higher in the recurrent patient group (n = 6, mean=16.23 ± 19.88) compared with the patients without recurrence (n = 78, mean=2.44 ± 5.62). Conclusions: No association was found between BPE and aggressiveness of the primary breast cancer, BPE and breast density. However, the mean BEC was higher in the patients who diagnosed local or systemic recurrence.

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