Tumor characteristics and family history in relation to mammographic density and breast cancer: The French E3N cohort |
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| Institution: | 1. University of Hawaii Cancer Center, Honolulu, HI, 9613, USA;2. CESP Inserm, Villejuif, France;3. Gustave Roussy, Villejuif, F-94805, France;4. Centre for Epidemiology and Biostatistics, Melbourne, VIC, Australia;5. Department of Clinical and Experimental Medicine, University of Pisa, Italy;1. Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, United States;2. Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, UT 84113, United States;3. Department of Institutional Research and Reporting, Salt Lake Community College, Salt Lake City, UT 84123, United States;4. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555, United States;5. Department of Pediatric Hematology/Oncology, Salt Lake City Primary Children’s Hospital, UT 84132, United States;6. Division of Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, United States;1. Department of Family Medicine and Community Health, JABSOM – University of Hawaii at Manoa, 677 Ala Moana Blvd, Suite 815, Honolulu, HI 96813, United States;2. Yap State Department of Health Services, P.O. Box 1010, Colonia, Yap 96943, Federated States of Micronesia;1. EPIUnit ? Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, no 135, 4050-600 Porto, Portugal;2. Registo Oncológico Regional do Norte (RORENO) ? Instituto Português de Oncologia do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;3. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal;1. Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark;2. Research Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark;3. Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Falkevej 1-3, 8600 Silkeborg, Denmark;4. Cancer Epidemiology and Population Health, King’s College London, Great Maze Pond, London SE1 9RT, United Kingdom;1. Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark;2. University Clinic for Innovative Patient Pathways, Silkeborg Hospital, Department of Clinical Medicine, Aarhus University, Falkevej 1-3, DK-8600 Silkeborg, Denmark |
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| Abstract: | BackgroundMammographic density is a known heritable risk factor for breast cancer, but reports how tumor characteristics and family history may modify this association are inconsistent.MethodsDense and total breast areas were assessed using Cumulus? from pre-diagnostic mammograms for 820 invasive breast cancer cases and 820 matched controls nested within the French E3N cohort study. To allow comparisons across models, percent mammographic density (PMD) was standardized to the distribution of the controls. Odds ratios (OR) and 95% confidence intervals (CI) of breast cancer risk for mammographic density were estimated by conditional logistic regression while adjusting for age and body mass index. Heterogeneity according to tumor characteristic and family history was assessed using stratified analyses.ResultsOverall, the OR per 1 SD for PMD was 1.50 (95% CI, 1.33–1.69). No evidence for significant heterogeneity by tumor size, lymph node status, grade, and hormone receptor status (estrogen, progesterone, and HER2) was detected. However, the association of PMD was stronger for women reporting a family history of breast cancer (OR1SD = 2.25; 95% CI, 1.67–3.04) than in women reporting none (OR1SD = 1.41; 95% CI, 1.24–1.60; pheterogeneity = 0.002). Similarly, effect modification by FHBC was observed using categories of PMD (pheterogeneity = 0.02) with respective ORs of 15.16 (95% CI, 4.23–54.28) vs. 3.14 (95% CI, 1.89–5.22) for ≥50% vs. <10% PMD.ConclusionsThe stronger association between mammographic density and breast cancer risk with a family history supports the hypothesis of shared genetic factors responsible for familial aggregation of breast cancer and the heritable component of mammographic density. |
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| Keywords: | Breast cancer Mammographic density Risk Prospective study Family history |
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