3,3'-Diindolylmethane (DIM): A nutritional intervention and its impact on breast density in healthy BRCA carriers compared to non-treated carriers—A prospective clinical trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1556-1556
Author(s):  
Rinat Yerushalmi ◽  
Sharon Bargil ◽  
Yaara Ber ◽  
Rachel Ozalvo ◽  
Sivan Sela ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Breast Density ◽  
Breast Imaging ◽  
Menopausal Status ◽  
Large Body ◽  
Independent Expert ◽  
Significant Change ◽  
One Year ◽  
Brca Carriers

1556 Background: Women who carry the BRCA mutation are at high lifetime risk of breast cancer, but there is no consensus regarding an effective and safe chemoprevention strategy. A large body of evidence suggests that 3,3-diindolylmethane (DIM), a dimer of indole-3-carbinol (I3C) found in cruciferous vegetables, can potentially prevent carcinogenesis and tumor development. The primary aim of this prospective study was to investigate the effect of DIM supplementation on breast density, a recognized predictive factor of breast-cancer risk. Methods: Participants were 23 healthy female BRCA carriers (median age 47 years; 78% postmenopausal) who were treated with oral DIM 100 mgx1/d for one year. The amount of fibroglandular tissue (FGT) and background parenchymal enhancement (BPE) on magnetic resonance imaging (MRI) performed before and after the intervention were scored by two independent expert radiologists using the Breast Imaging and Reporting Data System (BI-RADS). Each woman in the cohort was matched by age (within 3 years) and menopausal status to a woman attending the clinic who was not participating in the study and who underwent breast MRI in parallel year. Results: A decrease in the average score for FGT amount from 2.8±0.8 at onset to 2.65±0.842.8 after one year (p = 0.031), with no significant change in BPE (p = 0.429). A group of DIM-untreated age- and menopausal-status-matched clinic patients did not show a significant change in FGT amount (p = 0.33) or BPE (p = 0.814) in a parallel year. Mean estradiol level decreased from 159 to 102 pmol/L (p = 0.01), and mean testosterone level, from 0.42 to 0.31 pmol/L (p = 0.007). Side effects were grade 1. Conclusions: One year’s supplementation with DIM 100 mgX1/d in BRCA carriers was associated with a significant decline in FGT amount on MRI. Larger randomized studies are warranted to corroborate these findings. Clinical trial information: NCT02197000.

scholarly journals 3,3-Diindolylmethane (DIM): a nutritional intervention and its impact on breast density in healthy BRCA carriers. A prospective clinical trial

2020 ◽  
Vol 41 (10) ◽  
pp. 1395-1401 ◽  
Author(s):  
Rinat Yerushalmi ◽  
Sharon Bargil ◽  
Yaara Ber ◽  
Rachel Ozlavo ◽  
Tuval Sivan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Breast Imaging ◽  
Menopausal Status ◽  
Large Body ◽  
Average Score ◽  
Background Parenchymal Enhancement ◽  
Independent Expert ◽  
Significant Change ◽  
Brca Carriers

Abstract Women who carry the BRCA mutation are at high lifetime risk of breast cancer, but there is no consensus regarding an effective and safe chemoprevention strategy. A large body of evidence suggests that 3,3-diindolylmethane (DIM), a dimer of indole-3-carbinol found in cruciferous vegetables, can potentially prevent carcinogenesis and tumor development. The primary aim of this prospective single-arm study was to investigate the effect of DIM supplementation on breast density, a recognized predictive factor of breast cancer risk. Participants were 23 healthy female BRCA carriers (median age 47 years; 78% postmenopausal) who were treated with oral DIM 100 mg × 1/day for 1 year. The amount of fibroglandular tissue (FGT) and background parenchymal enhancement (BPE) on magnetic resonance imaging (MRI) performed before and after the intervention was scored by two independent expert radiologists using the Breast Imaging and Reporting Data System. The results showed a decrease in the average score for FGT amount from 2.8 ± 0.8 at the onset to 2.65 ± 0.84 after 1 year (P = 0.031), with no significant change in BPE (P = 0.429). A group of DIM-untreated age- and menopausal-status-matched women from the BRCA clinic did not show a significant change in FGT amount (P = 0.33) or BPE (P = 0.814) in a parallel year. Mean estradiol level decreased from 159 to 102 pmol/l (P = 0.01), and mean testosterone level decreased from 0.42 to 0.31 pmol/l (P = 0.007). Side effects were grade 1. In conclusion, 1 year’s supplementation with DIM 100 mg × 1/day in BRCA carriers was associated with a significant decline in FGT amount on MRI. Larger randomized studies are warranted to corroborate these findings.

Mammographic Breast Density: Effect on Imaging and Breast Cancer Risk

2010 ◽  
Vol 8 (10) ◽  
pp. 1157-1165 ◽  
Author(s):  
Renee W. Pinsky ◽  
Mark A. Helvie
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Menopausal Status ◽  
Masking Effect ◽  
Mammographic Breast Density ◽  
Ultrasound Screening ◽  
High Risk Women ◽  
Dense Breasts ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

Mammographic breast density has been studied for more than 30 years. Greater breast density not only is related to decreased sensitivity of mammograms because of a masking effect but also is a major independent risk factor for breast cancer. This article defines breast density and reviews literature on quantification of mammographic density that is key to future clinical and research protocols. Important influences on breast density are addressed, including age, menopausal status, exogenous hormones, and genetics of density. Young women with dense breasts benefit from digital mammographic technique. The potential use of supplemental MRI and ultrasound screening techniques in high-risk women and women with dense breasts is explored, as are potential risk reduction strategies.

scholarly journals Correlation Between Mammographic Breast Density, Breast Tissue Type in Ultrasonography, Fibroglandular Tissue, and Background Parenchymal Enhancement in Magnetic Resonance Imaging

2018 ◽  
Vol 12 ◽  
pp. 117822341877197 ◽  
Author(s):  
Afsaneh Alikhassi ◽  
Seyedeh Nooshin Miratashi Yazdi ◽  
Hedieh Akbari ◽  
Sona Akbari Kia ◽  
Masoud Baikpour
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Density ◽  
Menopausal Status ◽  
Mammographic Breast Density ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Background Parenchymal Enhancement ◽  
Parenchymal Enhancement

Objective: Breast cancer is the most common malignancy in the female population, and imaging studies play a critical role for its early detection. Mammographic breast density (MBD) is one of the markers used to predict the risk stratification of breast cancer in patients. We aimed to assess the correlations among MBD, ultrasound breast composition (USBC), fibroglandular tissue (FGT), and the amount of background parenchymal enhancement (BPE) in magnetic resonance imaging, after considering the subjects’ menopausal status. Methods: In this retrospective cross-sectional study, the medical records’ archives in a tertiary referral hospital were reviewed. Data including age, menopausal status, their mammograms, and ultrasound assessments were extracted from their records. All of their imaging studies were reviewed, and MBD, USBC, FGT, and BPE were determined, recorded, and entered into SPSS software for analysis. Results: A total of 121 women (mean age = 42.7 ± 11.0 years) were included, of which 35 out of 115 (30.4%) had reached menopause. Using the Jonckheere-Terpstra test for evaluating the trends among above mentioned 4 radiologic characteristics in the total sample population, a significant positive relation was found between each of these paired variables: (1) USBC-MBD ( P = .006), (2) FGT-MBD ( P = .001), (3) USBC-BPE ( P = .046), (4) USBC-FGT ( P = .036), and (5) BPE-FGT ( P < .001). These trends were not found to be significant among premenopausal subjects. Conclusions: Considering the trends between different measures of breast density in the 3 radiologic modalities, these factors can be used interchangeably in certain settings.

scholarly journals Heterogenous Effect of Risk Factors on Breast Cancer across the Breast Density Categories in a Korean Screening Population

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1391
Author(s):  
Boyoung Park ◽  
Se-Eun Lim ◽  
HyoJin Ahn ◽  
Junghyun Yoon ◽  
Yun Su Choi
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Postmenopausal Women ◽  
Breast Density ◽  
Breast Imaging ◽  
Hormone Replacement ◽  
Cancer Development ◽  
Age At Menarche ◽  
Breast Cancer Development ◽  
Heterogeneous Association

We evaluated the heterogeneity of the effect of known risk factors on breast cancer development based on breast density by using the Breast Imaging-Reporting and Data System (BI-RADS). In total, 4,898,880 women, aged 40–74 years, who participated in the national breast cancer screening program in 2009–2010 were followed up to December 2018. Increased age showed a heterogeneous association with breast cancer (1-year hazard ratio (HR) = 0.92, 1.00 (reference), 1.03, and 1.03 in women with BI-RADS density category 1, 2, 3, and 4, respectively; P-heterogeneity < 0.001). More advanced age at menopause increased breast cancer risk in all BI-RADS categories. This was more prominent in women with BI-RADS density category 1 but less prominent in women in other BI-RADS categories (P-heterogeneity = 0.009). In postmenopausal women, a family history of breast cancer, body mass index ≥ 25 kg/m2, and smoking showed a heterogeneous association with breast cancer across all BI-RADS categories. Other risk factors including age at menarche, menopause, hormone replacement therapy after menopause, oral contraceptive use, and alcohol consumption did not show a heterogeneous association with breast cancer across the BI-RADS categories. Several known risk factors of breast cancer had a heterogeneous effect on breast cancer development across breast density categories, especially in postmenopausal women.

The association between breast density and HER2-positive breast cancer: A population-based case-control study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12556-e12556
Author(s):  
Vivian Tan ◽  
Jennifer Payne ◽  
Nicole Paquet ◽  
Sian Iles ◽  
Daniel Rayson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Breast Screening ◽  
Hormone Replacement ◽  
Menopausal Status ◽  
Population Based ◽  
Case Control ◽  
Mammographic Breast Density ◽  
Her2 Positive ◽  
Increased Risk

e12556 Background: Little is known about the association between mammographic breast density and the subtypes of breast cancer including HER2-positive breast cancers (HER2-BrCa). The objective of this study was to assess the strength of association between breast density and HER2-BrCa in a population-based screening program. Methods: This is a population-based case-control breast cancer study of women aged 40 to 75 who underwent digital breast screening from 2009 to 2015 in Nova Scotia, Canada. Cases included women diagnosed with HER2-BrCa at screen or before their next screen (interval); controls included women without screen-detected cancer matched to cases by age and year of screen. Measures of mammographic breast density (percent density, BI-RADS-4th and -5th edition) were obtained from automated software (densitasai) and linked with clinical risk factor data (age, parity, total breast volume, post-menopausal status, hormone replacement therapy, family history and history of core biopsy). The association between breast density and cancer risk was assessed by calculating the odds ratios [OR] with 95% confidence intervals using multivariable logistic regression. Results: A total of 209 cases (median age, 58.8 years) and 6812 controls (median age, 59.4 years) were included. The risk of HER2-BrCa increased with increasing levels of percent breast density. High breast density according to BIRADS-4th and -5th editions was significantly associated with HER2-BrCa: BIRADS -4th 3/4 vs 1: OR 2.50 (1.68 - 3.68); BIRADS-5th C/D vs A: OR 2.58 (1.71 - 4.01). The association between higher breast density and increased risk of HER2-BrCa remained after adjustment for clinical factors. Conclusions: The risk of HER2-BrCa was associated with progressively higher mammographic breast density, although to a lesser extent than breast cancer in general. Accurate risk models including breast density may support the development of more breast-screening protocols that can lead to more strategic use of healthcare resources.

scholarly journals Breast Density and Breast Cancer Incidence in the Lebanese Population: Results from a Retrospective Multicenter Study

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Christine Salem ◽  
David Atallah ◽  
Joelle Safi ◽  
Georges Chahine ◽  
Antoine Haddad ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Breast Cancer Incidence ◽  
Menopausal Status ◽  
Western Society ◽  
Dense Breasts ◽  
Menopausal Women ◽  
Diagnostic Mammography ◽  
History Of ◽  
Retrospective Multicenter Study

Purpose. To study the distribution of breast mammogram density in Lebanese women and correlate it with breast cancer (BC) incidence.Methods. Data from 1,049 women who had screening or diagnostic mammography were retrospectively reviewed. Age, menopausal status, contraceptives or hormonal replacement therapy (HRT), parity, breastfeeding, history of BC, breast mammogram density, and final BI-RADS assessment were collected. Breast density was analyzed in each age category and compared according to factors that could influence breast density and BC incidence.Results. 120 (11.4%) patients had BC personal history with radiation and/or chemotherapy; 66 patients were postmenopausal under HRT. Mean age was52.58±11.90years. 76.4% of the patients (30–39 years) had dense breasts. Parity, age, and menopausal status were correlated to breast density whereas breastfeeding and personal/family history of BC and HRT were not. In multivariate analysis, it was shown that the risk of breast cancer significantly increases 3.3% with age (P=0.005), 2.5 times in case of menopause (P=0.004), and 1.4 times when breast density increases (P=0.014).Conclusion. Breast density distribution in Lebanon is similar to the western society. Similarly to other studies, it was shown that high breast density was statistically related to breast cancer, especially in older and menopausal women.

scholarly journals The Impact of Tumor Edema on T2-Weighted 3T-MRI Invasive Breast Cancer Histological Characterization: A Pilot Radiomics Study

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4635
Author(s):  
Domiziana Santucci ◽  
Eliodoro Faiella ◽  
Ermanno Cordelli ◽  
Alessandro Calabrese ◽  
Roberta Landi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Menopausal Status ◽  
Patient Data ◽  
Histological Type ◽  
Semantic Features ◽  
3T Mri ◽  
Histological Features ◽  
Mri Features ◽  
The Impact

Background: to evaluate the contribution of edema associated with histological features to the prediction of breast cancer (BC) prognosis using T2-weighted MRI radiomics. Methods: 160 patients who underwent staging 3T-MRI from January 2015 to January 2019, with 164 histologically proven invasive BC lesions, were retrospectively reviewed. Patient data (age, menopausal status, family history, hormone therapy), tumor MRI-features (location, margins, enhancement) and histological features (histological type, grading, ER, PgR, HER2, Ki-67 index) were collected. Of the 160 MRI exams, 120 were considered eligible, corresponding to 127 lesions. T2-MRI were used to identify edema, which was classified in four groups: peritumoral, pre-pectoral, subcutaneous, or diffuse. A semi-automatic segmentation of the edema was performed for each lesion, using 3D Slicer open-source software. Main radiomics features were extracted and selected using a wrapper selection method. A Random Forest type classifier was trained to measure the performance of predicting histological factors using semantic features (patient data and MRI features) alone and semantic features associated with edema radiomics features. Results: edema was absent in 37 lesions and present in 127 (62 peritumoral, 26 pre-pectoral, 16 subcutaneous, 23 diffuse). The AUC-classifier obtained by associating edema radiomics with semantic features was always higher compared to the AUC-classifier obtained from semantic features alone, for all five histological classes prediction (0.645 vs. 0.520 for histological type, 0.789 vs. 0.590 for grading, 0.487 vs. 0.466 for ER, 0.659 vs. 0.546 for PgR, and 0.62 vs. 0.573 for Ki67). Conclusions: radiomic features extracted from tumor edema contribute significantly to predicting tumor histology, increasing the accuracy obtained from the combination of patient clinical characteristics and breast imaging data.

The effect of raloxifene on breast MRI volume in premenopausal women at increased risk for invasive breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1518-1518
Author(s):  
J. Eng-Wong ◽  
C. K. Chow ◽  
J. Orzano ◽  
D. Venzon ◽  
J. Zujewski ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mammographic Density ◽  
Ductal Carcinoma ◽  
Premenopausal Women ◽  
Breast Mri ◽  
Rank Test ◽  
Increased Risk ◽  
Significant Change ◽  
One Year ◽  
Relative Change

1518 Background: Breast MRI volume (MRIV) and mammographic density (MD) assess the amount of fibroglandular tissue in the breast. While increased MD is associated with a 4 to 6 fold increase in breast cancer risk, the association between MRIV and breast cancer is unknown. Previous studies have shown that MRIV and MD can be modulated with hormonal interventions. We evaluated the effect of raloxifene on MRIV in premenopausal women at increased risk for breast cancer. We have previously reported that raloxifene did not change MD in this cohort. Raloxifene is indicated for the prevention and treatment of osteoporosis but not for prevention of breast cancer or for use in premenopausal women. Methods: Premenopausal women at increased risk by virtue of: Gail model risk > 1.7% over 5 years; lobular neoplasia, ductal carcinoma in situ, BRCA1/2 mutation positive, or a very strong family history were eligible for this phase II chemoprevention study. MRIs obtained at baseline and after two years on raloxifene 60 mg daily, and one year after discontinuing the drug were evaluated.T1 weighted spoiled gradient-echo MRI with fat suppression was used to determine volume using a semiautomatic method, after visual verification. Median relative change in MRIV was assessed by the Wilcoxon signed rank test. Results: 19 of 30 subjects who started study drug had breast MRI at baseline and after 2 years on raloxifene; median relative change was -16% (range -57 to +25%) (p=0.0004). 17 subjects had MRI at year 2 and one year after stopping drug. No significant change in MRIV was observed after stopping raloxifene, median relative change -9% (p=0.64). Conclusions: MRIV significantly declined while on raloxifene. In contrast no significant change in percent mammographic density in this same cohort was seen. Our findings suggest that MRIV may be a better surrogate biomarker than MD in premenopausal women at risk for breast cancer because of less variation in its measurement. MRIV should be further evaluated as a potential surrogate biomarker in prevention studies. No significant financial relationships to disclose.

Assessing community hospital compliance with NCCN breast cancer guidelines in diagnosis and treatment of stage IIb and IIIa breast cancer: A Fox Chase Cancer Center Partners (FCCCP) initiative

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6578-6578
Author(s):  
E. Gitelson ◽  
M. O'Grady ◽  
R. F. Swaby ◽  
L. J. Goldstein ◽  
T. Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Lymph Nodes ◽  
Medical Oncology ◽  
Menopausal Status ◽  
Cancer Center ◽  
Pathology Report ◽  
Axillary Lymph ◽  
Nccn Guidelines ◽  
Mean Compliance

6578 Background: The majority of cancer treatment occurs in community settings. NCCN guidelines are widely regarded as a marker for quality cancer care. We performed a retrospective review to assess compliance with NCCN guidelines at community medical oncology practices affiliated with FCCCP. Methods: Outpatient charts of 277 patients diagnosed with stage IIb/IIIa breast cancer between 2002–2005 from 16 medical oncology practices were assessed for the following documentation: charted pathology report with stage, ER, PR, and HER2/neu status noted, menopausal status, diagnostic mammogram, surgical evaluation, and radiation oncology consultation. The following treatments were evaluated: irradiation post-lumpectomy, sentinel and/or full axillary lymph node dissection (SLND and/or ALND), number of lymph nodes resected if ALND, use and type of chemotherapy, and accrual to a clinical trial. Results were compared with corresponding NCCN guidelines. Results: Percent compliance with NCCN guidelines by parameter for documentation were: pathology report (90.2%), staging (100%), ER/PR (92.4%), HER2/neu status (87.5%), menopausal status (92.3%), results of diagnostic mammogram (83.2%), and consultations of surgical (92.8%) and radiation oncologists (76%). For treatment, 85.1% of women had radiation post lumpectomy. SLND and/or ALND were performed in 96% of surgeries, with full ALND performed in 99% of cases with positive SLN. Eight or more lymph nodes were evaluated in 71.9% of patients. Overall, 83.7% of patients underwent chemotherapy, with 78.7% receiving regimens in compliance with NCCN guidelines. Clinical trial accrual was 6.2%, exceeding American College of Surgeons commendation standards for comprehensive community programs. Overall, mean percent compliance per NCCN parameter among practice groups was 87.8% (range 41.6 - 96%), with 15/16 hospitals achieving mean compliance above 80%. Conclusions: A comprehensive quality benchmark assessment of community medical oncology offices using NCCN guidelines is feasible. While overall compliance is high, areas deserving of education and improvement can be identified. No significant financial relationships to disclose.

Weight change in patients with treatment of breast cancer.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 127-127
Author(s):  
Lubna Chaudhary ◽  
Sijin Wen ◽  
Jie Xiao ◽  
Anne Swisher ◽  
Sobha Kurian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Menopausal Status ◽  
Distant Recurrence ◽  
Current Treatment ◽  
Stage Iii ◽  
Rank Test ◽  
Therapeutic Modalities ◽  
Treatment Regimens ◽  
Kaplan Meier ◽  
Significant Change

127 Background: Studies have shown that breast cancer (BC) treatment can increase weight (wt). Wt gain during chemotherapy is usually significant and maybe associated with poor survival. Role of current treatment regimens and wt gain is not reviewed. Methods: We retrospectively analyzed the mean percentage (%) wt change during the 1st year following BC diagnosis in 246 patients (pts) between Sept 2007 and Oct 2010. Kruskal-Wallis test and post-hoc pairwise comparisons were used to assess the influence of various factors including age, histology, stage, ER/PR/HER-2/neu status, menopausal status and types of therapeutic modalities received on the % wt change. Kaplan-Meier method with log-rank test was used to evaluate recurrence free survival (RFS). Local or distant recurrence and disease progression were events for RFS analysis and disease-free pts were censored at last follow-up. Results: Mean wt gain was 0.39% (±0.40) at 1 year from diagnosis of BC. Premenopausal status was the only factor associated with significant wt gain (+1.67% vs. -0.10% for postmenopausal pts; p=0.02). Stage ≥ III was associated with significant wt loss (-1.64% for III/IV vs. +0.85% for 0/I/II; p=0.02) and a lower RFS at 3yrs and 5yrs (p< 0.0001). Higher baseline wt (>90th percentile) did not have any significant impact on RFS at 3 years (0.84 vs. 0.91; p=0.19). There was no significant change in wt relative to other factors as shown in Table. Conclusions: Our study using current treatment regimens did not show any significant change in % wt with chemotherapy during the 1st year of BC diagnosis. Premenopausal status was the only factor associated with significant wt gain while stage ≥ III was associated with significant wt loss and lower RFS. [Table: see text]

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