Ethnic and age differences in right-left breast asymmetry in a large population-based screening population

Objective: Exposure to sex hormones is important in the pathogenesis of breast cancer and inability to tolerate such exposure may be reflected in increased asymmetrical growth of the breasts. This study aims to characterize, for the first time, asymmetry in breast volume (BV) and radiodense volume (DV) in a large ethnically diverse population. Methods: Automated measurements from digital raw mammographic images of 54,591 cancer-free participants (aged 47–73) in a UK breast screening programme were used to calculate absolute (cm3) and relative asymmetry in BV and DV. Logistic regression models were fitted to assess asymmetry associations with age and ethnicity. Results: BV and DV absolute asymmetry were positively correlated with the corresponding volumetric dimension (BV or DV). BV absolute asymmetry increased, whilst DV absolute asymmetry decreased, with increasing age (P-for-linear-trend <0.001 for both). Relative to Whites, Blacks had statistically significantly higher, and Chinese lower, BV and DV absolute asymmetries. However, after adjustment for the corresponding underlying volumetric dimension the age and ethnic differences were greatly attenuated. Median relative (fluctuating) BV and DV asymmetry were 2.34 and 3.28% respectively. Conclusion: After adjusting for the relevant volumetric dimension (BV or DV), age and ethnic differences in absolute breast asymmetry were largely resolved. Advances in knowledge: Previous small studies have reported breast asymmetry—breast cancer associations. Automated measurements of asymmetry allow the conduct of large-scale studies to further investigate these associations.

Download Full-text

Left–right breast asymmetry and risk of screen-detected and interval cancers in a large population-based screening population

British Journal of Radiology ◽

10.1259/bjr.20200154 ◽

2020 ◽

Vol 93 (1112) ◽

pp. 20200154

Author(s):

Sue M Hudson ◽

Louise S Wilkinson ◽

Bianca L De Stavola ◽

Isabel dos-Santos-Silva

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Cancer Diagnosis ◽

Linear Trend ◽

Conditional Logistic Regression ◽

Large Population ◽

Interval Cancer ◽

Population Based ◽

Breast Cancers ◽

Interval Cancers

Objectives: To assess the associations between automated volumetric estimates of mammographic asymmetry and breast cancers detected at the same (“contemporaneous”) screen, at subsequent screens, or in between (interval cancers). Methods: Automated measurements from mammographic images (N = 79,731) were used to estimate absolute asymmetry in breast volume (BV) and dense volume (DV) in a large ethnically diverse population of attendees of a UK breast screening programme. Logistic regression models were fitted to assess asymmetry associations with the odds of a breast cancer detected at contemporaneous screen (767 cases), adjusted for relevant confounders. Nested case–control investigations were designed to examine associations between asymmetry and the odds of: (a) interval cancer (numbers of cases/age-matched controls: 153/646) and (b) subsequent screen-detected cancer (345/1438), via conditional logistic regression. Results: DV, but not BV, asymmetry was positively associated with the odds of contemporaneous breast cancer (P-for-linear-trend (Pt) = 0.018). This association was stronger for first (prevalent) screens (Pt = 0.012). Both DV and BV asymmetry were positively associated with the odds of an interval cancer diagnosis (Pt = 0.060 and 0.030, respectively). Neither BV nor DV asymmetry were associated with the odds of having a subsequent screen-detected cancer. Conclusions: Increased DV asymmetry was associated with the risk of a breast cancer diagnosis at a contemporaneous screen or as an interval cancer. BV asymmetry was positively associated with the risk of an interval cancer diagnosis. Advances in knowledge: The findings suggest that DV and BV asymmetry may provide additional signals for detecting contemporaneous cancers and assessing the likelihood of interval cancers in population-based screening programmes.

Download Full-text

Adjuvant Hormonotherapy and Cardiovascular Risk in Post-Menopausal Women with Breast Cancer: A Large Population-Based Cohort Study

Cancers ◽

10.3390/cancers13092254 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2254

Author(s):

Matteo Franchi ◽

Roberta Tritto ◽

Luigi Tarantini ◽

Alessandro Navazio ◽

Giovanni Corrao

Keyword(s):

Breast Cancer ◽

Heart Failure ◽

Adjuvant Therapy ◽

Large Population ◽

Positive Association ◽

Population Based ◽

Study Cohort ◽

Increased Risk ◽

Post Menopausal ◽

New Diagnosis

Background: Whether aromatase inhibitors (AIs) increase the risk of cardiovascular (CV) events, compared to tamoxifen, in women with breast cancer is still debated. We evaluated the association between AI and CV outcomes in a large population-based cohort of breast cancer women. Methods: By using healthcare utilization databases of Lombardy (Italy), we identified women ≥50 years, with new diagnosis of breast cancer between 2009 and 2015, who started adjuvant therapy with either AI or tamoxifen. We estimated the association between exposure to AI and CV outcomes (including myocardial infarction, ischemic stroke, heart failure or any CV event) by a Cox proportional hazard model with inverse probability of treatment and censoring weighting. Results: The study cohort included 26,009 women starting treatment with AI and 7937 with tamoxifen. Over a median follow-up of 5.8 years, a positive association was found between AI and heart failure (Hazard Ratio = 1.20, 95% CI: 1.02 to 1.42) and any CV event (1.14, 1.00 to 1.29). The CV risk increased in women with previous CV risk factors, including hypertension, diabetes and dyslipidemia. Conclusions: Adjuvant therapy with AI in breast cancer women aged more than 50 years is associated with increased risk of heart failure and combined CV events.

Download Full-text

Adherence to guidelines and benefit of adjuvant radiotherapy in patients with invasive breast cancer: results from a large population-based cohort study of a cancer registry

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-018-5030-z ◽

2019 ◽

Vol 299 (4) ◽

pp. 1131-1140

Author(s):

Theresa Wimmer ◽

Olaf Ortmann ◽

Michael Gerken ◽

Monika Klinkhammer-Schalke ◽

Oliver Koelbl ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Cancer Registry ◽

Invasive Breast Cancer ◽

Adjuvant Radiotherapy ◽

Large Population ◽

Population Based ◽

Adherence To Guidelines

Download Full-text

Serum 25-hydroxyvitamin D and risk of breast cancer: results of a large population-based case–control study in Mexican women

Cancer Causes & Control ◽

10.1007/s10552-012-9984-z ◽

2012 ◽

Vol 23 (7) ◽

pp. 1149-1162 ◽

Cited By ~ 26

Author(s):

Veronika Fedirko ◽

Gabriela Torres-Mejía ◽

Carolina Ortega-Olvera ◽

Carine Biessy ◽

Angelica Angeles-Llerenas ◽

...

Keyword(s):

Breast Cancer ◽

Case Control Study ◽

Large Population ◽

Population Based ◽

Case Control ◽

Mexican Women ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Control Study

Download Full-text

Blood and CSF biomarkers in brain subcortical ischemic vascular disease: Involved pathways and clinical applicability

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2015.68 ◽

2015 ◽

Vol 36 (1) ◽

pp. 55-71 ◽

Cited By ~ 24

Author(s):

A Vilar-Bergua ◽

I Riba-Llena ◽

C Nafría ◽

A Bustamante ◽

V Llombart ◽

...

Keyword(s):

Cognitive Impairment ◽

Vascular Disease ◽

Large Scale ◽

Small Vessel Disease ◽

Large Population ◽

Vascular Cognitive Impairment ◽

Population Based ◽

Endothelial Damage ◽

Csf Biomarkers ◽

Lacunar Infarcts

Vascular dementia is the second most common type of dementia after Alzheimer’s disease (AD). Subcortical ischemic vascular disease refers to a form of vascular cognitive impairment characterized by the presence of diffuse white matter hyperintensities (WMHs) and multiple lacunar infarcts. These neuroimaging findings are mainly caused by cerebral small-vessel disease (cSVD) and relate to aging and cognitive impairment, but they can also be silent and highly prevalent in otherwise healthy individuals. We aimed to review studies on blood and cerebrospinal fluid (CSF) markers related to the presence of WMHs and lacunar infarcts that have been conducted in the past in large population-based studies and in high-risk selected patients (such as those with vascular risk factors, vascular cognitive impairment, or AD). Relevant associations with the presence and progression of cSVD have been described in the blood for markers related to inflammatory processes, endothelial damage and coagulation/fibrinolysis processes, etc. Also, different combinations of CSF markers might help to differentiate between etiologic types of dementia. In the future, to translate these findings into clinical practice and use biomarkers to early diagnosis and monitoring vascular cognitive impairment would require the replication of candidate markers in large-scale, multicenter, and prospectively designed studies.

Download Full-text

Statin Use and Breast Cancer Risk in a Large Population-Based Setting

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-06-0737 ◽

2007 ◽

Vol 16 (3) ◽

pp. 416-421 ◽

Cited By ~ 60

Author(s):

Denise M. Boudreau ◽

Onchee Yu ◽

Diana L. Miglioretti ◽

Diana S.M. Buist ◽

Susan R. Heckbert ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Large Population ◽

Population Based ◽

Statin Use

Download Full-text

Familial CLL: Genes and Environment

Hematology ◽

10.1182/asheducation-2007.1.339 ◽

2007 ◽

Vol 2007 (1) ◽

pp. 339-345 ◽

Cited By ~ 16

Author(s):

Lynn R. Goldin ◽

Susan L. Slager

Keyword(s):

B Cell ◽

Large Scale ◽

Familial Aggregation ◽

Association Studies ◽

Large Population ◽

Gene Mutations ◽

Population Based ◽

Lymphocytic Leukemia ◽

Genes And Environment ◽

The U.S

Abstract Families with multiple individuals affected with chronic lymphocytic leukemia (CLL) and other related B-cell tumors have been described in the literature. Familial CLL does not appear to differ from sporadic CLL in terms of prognostic markers and clinical outcome. While some environmental factors (such as farming-related exposures and occupational chemicals) may increase risk of CLL, results of epidemiologic studies have been generally inconsistent. Rates of CLL in the population show significant international variation, with the highest rates in the U.S. and Europe and the lowest rates in Asia. Migrants from Asia to the U.S. also have low rates of CLL, which supports a greater role for genetic compared with environmental risk factors. Large, population-based case-control and cohort studies have also shown significant familial aggregation of CLL and related conditions including non-Hodgkin and Hodgkin lymphoma. Monoclonal B-cell lymphocytosis also aggregates in families with CLL. However, the clinical implication of familial aggregation is minimal given the overall rarity of CLL. Linkage studies have been conducted in high-risk CLL families to screen the whole genome for loci that contribute to susceptibility, but no gene mutations have yet been identified by this method. Association studies of candidate genes have implicated immune function and other genes, but more studies are needed to verify these findings. The ability to conduct large-scale genomic studies will play an important role in detecting susceptibility genes for CLL over the next few years and thereby help to delineate etiologic pathways.

Download Full-text

Occupational Exposure to Electromagnetic Field and Breast Cancer Risk in a Large, Population-Based, Case-Control Study in the United States

Journal of Occupational and Environmental Medicine ◽

10.1097/jom.0b013e318032259b ◽

2007 ◽

Vol 49 (3) ◽

pp. 266-274 ◽

Cited By ~ 26

Author(s):

Jane A. McElroy ◽

Kathleen M. Egan ◽

Linda Titus-Ernstoff ◽

Henry A. Anderson ◽

Amy Trentham-Dietz ◽

...

Keyword(s):

Breast Cancer ◽

United States ◽

Electromagnetic Field ◽

Breast Cancer Risk ◽

Case Control Study ◽

Large Population ◽

The United States ◽

Population Based ◽

Case Control ◽

Control Study

Download Full-text

Long-Term Survival Among Patients With Hodgkin's Lymphoma Who Developed Breast Cancer: A Population-Based Study

Journal of Clinical Oncology ◽

10.1200/jco.2010.29.5683 ◽

2010 ◽

Vol 28 (34) ◽

pp. 5088-5096 ◽

Cited By ~ 52

Author(s):

Michael T. Milano ◽

Huilin Li ◽

Mitchell H. Gail ◽

Louis S. Constine ◽

Lois B. Travis

Keyword(s):

Breast Cancer ◽

Cardiac Disease ◽

Hodgkin’S Lymphoma ◽

Large Population ◽

Population Based ◽

Hazard Ratio ◽

Hodgkin's Lymphoma ◽

Term Survival ◽

Distant Disease ◽

Increased Risk

Purpose The increased risk of breast cancer (BC) among women receiving chest radiotherapy for Hodgkin's lymphoma (HL) is well-established. However, there are no large population-based studies that describe overall survival (OS) and cause-specific survival (CSS) compared with women with first primary BC. Methods For 298 HL survivors who developed BC (HL-BC group) and 405,223 women with a first or only BC (BC-1 group), actuarial OS and CSS were compared, accounting for age, BC stage, hormone receptor status, sociodemographic status, radiation for HL, and other variables. All patients were derived from the population-based Surveillance, Epidemiology, and End Results program. Results OS among patients with HL-BC was significantly inferior that of to patients with BC-1: 15-year OS was 48% versus 69% (P < .0001) for localized BC, and 33% versus 43% (P < .0001) for regional/distant BC. Patients with HL-BC had a significantly increased seven-fold risk (P < .0001) of death from other cancers (ie, not HL or BC) compared with patients with BC-1. Mortality from heart disease among patients with HL-BC with either localized or regional/distant disease was also significantly increased (hazard ratio = 2.22, P = .04; and hazard ratio = 4.28, P = .02, respectively) compared with patients with BC-1. Although 10-year BC-CSS was similar for patients with HL-BC and BC-1 with regional/distant disease, it was inferior for patients with localized BC (82% v 88%, respectively; P = .002). Conclusion Women with HL may survive a subsequent diagnosis of BC, only to experience significant excesses of death from other primary cancers and cardiac disease. Greater awareness of screening for cardiac disease and subsequent primary cancers in patients with HL-BC is warranted.

Download Full-text