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Jiménez T, Domínguez-Castillo A, Fernández de Larrea-Baz N, Lucas P, Sierra MÁ, Salas-Trejo D, Llobet R, Martínez I, Pino MN, Martínez-Cortés M, Pérez-Gómez B, Pollán M, Lope V, García-Pérez J. Residential exposure to traffic pollution and mammographic density in premenopausal women. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172463. [PMID: 38615764 DOI: 10.1016/j.scitotenv.2024.172463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Mammographic density (MD) is the most important breast cancer biomarker. Ambient pollution is a carcinogen, and its relationship with MD is unclear. This study aims to explore the association between exposure to traffic pollution and MD in premenopausal women. METHODOLOGY This Spanish cross-sectional study involved 769 women attending gynecological examinations in Madrid. Annual Average Daily Traffic (AADT), extracted from 1944 measurement road points provided by the City Council of Madrid, was weighted by distances (d) between road points and women's addresses to develop a Weighted Traffic Exposure Index (WTEI). Three methods were employed: method-1 (1dAADT), method-2 (1dAADT), and method-3 (e1dAADT). Multiple linear regression models, considering both log-transformed percentage of MD and untransformed MD, were used to estimate MD differences by WTEI quartiles, through two strategies: "exposed (exposure buffers between 50 and 200 m) vs. not exposed (>200 m)"; and "degree of traffic exposure". RESULTS Results showed no association between MD and traffic pollution according to buffers of exposure to the WTEI (first strategy) for the three methods. The highest reductions in MD, although not statistically significant, were detected in the quartile with the highest traffic exposure. For instance, method-3 revealed a suggestive inverse trend (eβQ1 = 1.23, eβQ2 = 0.96, eβQ3 = 0.85, eβQ4 = 0.85, p-trend = 0.099) in the case of 75 m buffer. Similar non-statistically significant trends were observed with Methods-1 and -2. When we examined the effect of traffic exposure considering all the 1944 measurement road points in every participant (second strategy), results showed no association for any of the three methods. A slightly decreased MD, although not significant, was observed only in the quartile with the highest traffic exposure: eβQ4 = 0.98 (method-1), and eβQ4 = 0.95 (methods-2 and -3). CONCLUSIONS Our results showed no association between exposure to traffic pollution and MD in premenopausal women. Further research is needed to validate these findings.
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Affiliation(s)
- Tamara Jiménez
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid (UAM), Madrid, Spain; HM CINAC (Centro Integral de Neurociencias AC), Hospital Universitario Puerta del Sur, Fundación HM Hospitales, Móstoles, Spain
| | - Alejandro Domínguez-Castillo
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain.
| | - Nerea Fernández de Larrea-Baz
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Pilar Lucas
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain.
| | - María Ángeles Sierra
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Dolores Salas-Trejo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Valencian Breast Cancer Screening Program, General Directorate of Public Health, Valencia, Spain; Center for Public Health Research CSISP, FISABIO, Valencia, Spain.
| | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, Valencia, Spain.
| | - Inmaculada Martínez
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, Valencia, Spain; Center for Public Health Research CSISP, FISABIO, Valencia, Spain.
| | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain.
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain.
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
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Li X, Li X, Zhang K, Guan Y, Fan M, Wu Q, Li Y, Holmdahl R, Lu S, Zhu W, Wang X, Meng L. Autoantibodies against Endophilin A2 as a novel biomarker are beneficial to early diagnosis of breast cancer. Clin Chim Acta 2024; 560:119748. [PMID: 38796051 DOI: 10.1016/j.cca.2024.119748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/24/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Due to the lack of early symptoms, breast cancer is frequently overlooked, leading to distant metastases and multi-organ lesions that directly threaten patients' lives. We have identified a novel tumor marker, antibodies to endophilin A2 (EA2), to improve early diagnosis of breast cancer. METHODS Antibody levels of EA2 were analyzed in sera of patients with cancers of different origins and stages by indirect enzyme-linked immunosorbent assay (ELISA). Diagnostic accuracy and reference range were determined by the area under the receiver operating curve and distribution curve. The levels of EA2 antigen in sera were determined by sandwich ELISA. RESULTS The levels of antibodies against EA2 were higher in sera of patients with breast cancer (P < 0.0001), liver cancer (P = 0.0005), gastric cancer (P = 0.0026), and colon cancer (P = 0.0349) than those in healthy controls, but not in patients with rectal cancer (P = 0.1151), leukemia (P = 0.7508), or lung cancer (P = 0.2247). The highest diagnostic value was for breast cancer, particularly in early cases (AUC = 0.8014) and those with distant metastases (AUC = 0.7885). The titers of EA2 antibodies in sera were correlated with levels of EA2 antigen in breast cancer patients. CONCLUSION Antibodies to EA2 are novel blood biomarkers for early diagnosis of breast cancer that warrants further study in larger-scale cohort studies.
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Affiliation(s)
- Xiaomeng Li
- National-Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Xiaowei Li
- National-Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Kaige Zhang
- School of Medical Technology, Xinxiang Medical University, Xinxiang, Henan 453003, China; Department of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yanglong Guan
- Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Meiyang Fan
- Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Qian Wu
- Department of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yue Li
- Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Rikard Holmdahl
- National-Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm 17177, Sweden
| | - Shemin Lu
- National-Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi 710061, China
| | - Wenhua Zhu
- National-Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China.
| | - Xiaoqin Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
| | - Liesu Meng
- National-Local Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi 710061, China
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Vabistsevits M, Davey Smith G, Richardson TG, Richmond RC, Sieh W, Rothstein JH, Habel LA, Alexeeff SE, Lloyd-Lewis B, Sanderson E. Mammographic density mediates the protective effect of early-life body size on breast cancer risk. Nat Commun 2024; 15:4021. [PMID: 38740751 DOI: 10.1038/s41467-024-48105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
The unexplained protective effect of childhood adiposity on breast cancer risk may be mediated via mammographic density (MD). Here, we investigate a complex relationship between adiposity in childhood and adulthood, puberty onset, MD phenotypes (dense area (DA), non-dense area (NDA), percent density (PD)), and their effects on breast cancer. We use Mendelian randomization (MR) and multivariable MR to estimate the total and direct effects of adiposity and age at menarche on MD phenotypes. Childhood adiposity has a decreasing effect on DA, while adulthood adiposity increases NDA. Later menarche increases DA/PD, but when accounting for childhood adiposity, this effect is attenuated. Next, we examine the effect of MD on breast cancer risk. DA/PD have a risk-increasing effect on breast cancer across all subtypes. The MD SNPs estimates are heterogeneous, and additional analyses suggest that different mechanisms may be linking MD and breast cancer. Finally, we evaluate the role of MD in the protective effect of childhood adiposity on breast cancer. Mediation MR analysis shows that 56% (95% CIs [32%-79%]) of this effect is mediated via DA. Our finding suggests that higher childhood adiposity decreases mammographic DA, subsequently reducing breast cancer risk. Understanding this mechanism is important for identifying potential intervention targets.
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Affiliation(s)
- Marina Vabistsevits
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK.
- University of Bristol, Population Health Sciences, Bristol, UK.
| | - George Davey Smith
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
| | - Tom G Richardson
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
| | - Rebecca C Richmond
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
| | - Weiva Sieh
- Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, New York, NY, USA
- University of Texas MD Anderson Cancer Center, Department of Epidemiology, Houston, TX, USA
| | - Joseph H Rothstein
- Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, New York, NY, USA
- University of Texas MD Anderson Cancer Center, Department of Epidemiology, Houston, TX, USA
| | - Laurel A Habel
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA
| | - Stacey E Alexeeff
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA
| | - Bethan Lloyd-Lewis
- University of Bristol, School of Cellular and Molecular Medicine, Bristol, UK
| | - Eleanor Sanderson
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
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Pereira A, Garmendia ML, Leiva V, Corvalán C, Michels KB, Shepherd J. Breast composition during and after puberty: the Chilean Growth and Obesity Cohort Study. Breast Cancer Res 2024; 26:45. [PMID: 38475816 DOI: 10.1186/s13058-024-01793-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Breast density (BD) is a strong risk factor for breast cancer. Little is known about how BD develops during puberty. Understanding BD trajectories during puberty and its determinants could be crucial for promoting preventive actions against breast cancer (BC) at early ages. The objective of this research is to characterize % fibroglandular volume (%FGV), absolute fibroglandular volume (AFGV), and breast volume (BV) at different breast Tanner stages until 4-year post menarche in a Latino cohort and to assess determinants of high %FGV and AFGV during puberty and in a fully mature breast. METHODS This is a longitudinal follow-up of 509 girls from low-middle socioeconomic status of the Southeast area of Santiago, recruited at a mean age of 3.5 years. The inclusion criteria were singleton birth born, birthweight between 2500 and 4500 g with no medical or mental disorder. A trained dietitian measured weight and height since 3.5 years old and sexual maturation from 8 years old (breast Tanner stages and age at menarche onset). Using standardized methods, BD was measured using dual-energy X-ray absorptiometry (DXA) in various developmental periods (breast Tanner stage B1 until 4 years after menarche onset). RESULTS In the 509 girls, we collected 1,442 breast DXA scans; the mean age at Tanner B4 was 11.3 years. %FGV increased across breast Tanner stages and peaked 250 days after menarche. AFGV and BV peaked 2 years after menarche onset. Girls in the highest quartiles of %FGV, AFGV, and BV at Tanner B4 and B5 before menarche onset had the highest values thereafter until 4 years after menarche onset. The most important determinants of %FGV and AFGV variability were BMI z-score (R2 = 44%) and time since menarche (R2 = 42%), respectively. CONCLUSION We characterize the breast development during puberty, a critical window of susceptibility. Although the onset of menarche is a key milestone for breast development, we observed that girls in the highest quartiles of %FGV and AFGV tracked in that group afterwards. Following these participants in adulthood would be of interest to understand the changes in breast composition during this period and its potential link with BC risk.
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Affiliation(s)
- Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | | | - Valeria Leiva
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Camila Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - John Shepherd
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawaii Cancer Center, Honolulu, HI, USA
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Han Y, Otegbeye EE, Stoll C, Hardi A, Colditz GA, Toriola AT. How does weight gain since the age of 18 years affect breast cancer risk in later life? A meta-analysis. Breast Cancer Res 2024; 26:39. [PMID: 38454466 PMCID: PMC10921610 DOI: 10.1186/s13058-024-01804-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 03/03/2024] [Indexed: 03/09/2024] Open
Abstract
Early life factors are important risk factors for breast cancer. The association between weight gain after age 18 and breast cancer risk is inconsistent across previous epidemiologic studies. To evaluate this association, we conducted a meta-analysis according to PRISMA guidelines and the established inclusion criteria. We performed a comprehensive literature search using Medline (Ovid), Embase, Scopus, Cochrane Library, and ClinicalTrials.gov to identify relevant studies published before June 3, 2022. Two reviewers independently reviewed the articles for final inclusion. Seventeen out of 4,725 unique studies met the selection criteria. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS), and all were of moderate to high quality with NOS scores ranging from 5 to 8. We included 17 studies (11 case-control, 6 cohort) in final analysis. In case-control studies, weight gain after age 18 was associated with an increased risk of breast cancer (odds ratio [OR] = 1.25; 95% CI = 1.07-1.48), when comparing the highest versus the lowest categories of weight gain. Menopausal status was a source of heterogeneity, with weight gain after age 18 associated with an increased risk of breast cancer in postmenopausal women (OR = 1.53; 95% CI = 1.40-1.68), but not in premenopausal women (OR = 1.01; 95% CI = 0.92-1.12). Additionally, a 5 kg increase in weight was positively associated with postmenopausal breast cancer risk (OR = 1.12; 95%CI = 1.05-1.21) in case-control studies. Findings from cohort studies were identical, with a positive association between weight gain after age 18 and breast cancer incidence in postmenopausal women (relative risk [RR] = 1.30; 95% CI = 1.09-1.36), but not in premenopausal women (RR = 1.06; 95% CI = 0.92-1.22). Weight gain after age 18 is a risk factor for postmenopausal breast cancer, highlighting the importance of weight control from early adulthood to reduce the incidence of postmenopausal breast cancer.
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Affiliation(s)
- Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Ebunoluwa E Otegbeye
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Carrie Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Angela Hardi
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA.
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA.
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Leineweber WD, Rowell MZ, Ranamukhaarachchi S, Walker A, Li Y, Villazon J, Farrera AM, Hu Z, Yang J, Shi L, Fraley SI. Divergent iron-regulatory states contribute to heterogeneity in breast cancer aggressiveness. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.06.23.546216. [PMID: 37425829 PMCID: PMC10327122 DOI: 10.1101/2023.06.23.546216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Primary tumors with similar mutational profiles can progress to vastly different outcomes where transcriptional state, rather than mutational profile, predicts prognosis. A key challenge is to understand how distinct tumor cell states are induced and maintained. In triple negative breast cancer cells, invasive behaviors and aggressive transcriptional signatures linked to poor patient prognosis can emerge in response to contact with collagen type I. Herein, collagen-induced migration heterogeneity within a TNBC cell line was leveraged to identify transcriptional programs associated with invasive versus non-invasive phenotypes and implicate molecular switches. Phenotype-guided sequencing revealed that invasive cells upregulate iron uptake and utilization machinery, anapleurotic TCA cycle genes, actin polymerization promoters, and a distinct signature of Rho GTPase activity and contractility regulating genes. The non-invasive cell state is characterized by actin and iron sequestration modules along with glycolysis gene expression. These unique tumor cell states are evident in patient tumors and predict divergent outcomes for TNBC patients. Glucose tracing confirmed that non-invasive cells are more glycolytic than invasive cells, and functional studies in cell lines and PDO models demonstrated a causal relationship between phenotype and metabolic state. Mechanistically, the OXPHOS dependent invasive state resulted from transient HO-1 upregulation triggered by contact with dense collagen that reduced heme levels and mitochondrial chelatable iron levels. This induced expression of low cytoplasmic iron response genes regulated by ACO1/IRP1. Knockdown or inhibition of HO-1, ACO1/IRP1, MRCK, or OXPHOS abrogated invasion. These findings support an emerging theory that heme and iron flux serve as important regulators of TNBC aggressiveness.
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Jung S, Silva S, Dallal CM, LeBlanc E, Paris K, Shepherd J, Snetselaar LG, Van Horn L, Zhang Y, Dorgan JF. Untargeted serum metabolomic profiles and breast density in young women. Cancer Causes Control 2024; 35:323-334. [PMID: 37737303 DOI: 10.1007/s10552-023-01793-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE OF THE STUDY Breast density is an established risk factor for breast cancer. However, little is known about metabolic influences on breast density phenotypes. We conducted untargeted serum metabolomics analyses to identify metabolic signatures associated with breast density phenotypes among young women. METHODS In a cross-sectional study of 173 young women aged 25-29 who participated in the Dietary Intervention Study in Children 2006 Follow-up Study, 449 metabolites were measured in fasting serum samples using ultra-high-performance liquid chromatography-tandem mass spectrometry. Multivariable-adjusted mixed-effects linear regression identified metabolites associated with magnetic resonance imaging measured breast density phenotypes: percent dense breast volume (%DBV), absolute dense breast volume (ADBV), and absolute non-dense breast volume (ANDBV). Metabolite results were corrected for multiple comparisons using a false discovery rate adjusted p-value (q). RESULTS The amino acids valine and leucine were significantly inversely associated with %DBV. For each 1 SD increase in valine and leucine, %DBV decreased by 20.9% (q = 0.02) and 18.4% (q = 0.04), respectively. ANDBV was significantly positively associated with 16 lipid and one amino acid metabolites, whereas no metabolites were associated with ADBV. Metabolite set enrichment analysis also revealed associations of distinct metabolic signatures with %DBV, ADBV, and ANDBV; branched chain amino acids had the strongest inverse association with %DBV (p = 0.002); whereas, diacylglycerols and phospholipids were positively associated with ANDBV (p ≤ 0.002), no significant associations were observed for ADBV. CONCLUSION Our results suggest an inverse association of branched chain amino acids with %DBV. Larger studies in diverse populations are needed.
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Affiliation(s)
- Seungyoun Jung
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, South Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, South Korea
| | - Sarah Silva
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cher M Dallal
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Erin LeBlanc
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Kenneth Paris
- Department of Pediatrics, Louisiana State University School of Medicine, New Orleans, LA, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yuji Zhang
- Division of Cancer Epidemiology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood St., Howard Hall, Room 102E, Baltimore, MD, 21201, USA
| | - Joanne F Dorgan
- Division of Cancer Epidemiology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood St., Howard Hall, Room 102E, Baltimore, MD, 21201, USA.
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8
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Mao X, He W, Humphreys K, Eriksson M, Holowko N, Yang H, Tapia J, Hall P, Czene K. Breast Cancer Incidence After a False-Positive Mammography Result. JAMA Oncol 2024; 10:63-70. [PMID: 37917078 PMCID: PMC10623302 DOI: 10.1001/jamaoncol.2023.4519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/26/2023] [Indexed: 11/03/2023]
Abstract
Importance False-positive mammography results are common. However, long-term outcomes after a false-positive result remain unclear. Objectives To examine long-term outcomes after a false-positive mammography result and to investigate whether the association of a false-positive mammography result with cancer differs by baseline characteristics, tumor characteristics, and time since the false-positive result. Design, Setting, and Participants This population-based, matched cohort study was conducted in Sweden from January 1, 1991, to March 31, 2020. It included 45 213 women who received a first false-positive mammography result between 1991 and 2017 and 452 130 controls matched on age, calendar year of mammography, and screening history (no previous false-positive result). The study also included 1113 women with a false-positive result and 11 130 matched controls with information on mammographic breast density from the Karolinska Mammography Project for Risk Prediction of Breast Cancer study. Statistical analysis was performed from April 2022 to February 2023. Exposure A false-positive mammography result. Main Outcomes and Measures Breast cancer incidence and mortality. Results The study cohort included 497 343 women (median age, 52 years [IQR, 42-59 years]). The 20-year cumulative incidence of breast cancer was 11.3% (95% CI, 10.7%-11.9%) among women with a false-positive result vs 7.3% (95% CI, 7.2%-7.5%) among those without, with an adjusted hazard ratio (HR) of 1.61 (95% CI, 1.54-1.68). The corresponding HRs were higher among women aged 60 to 75 years at the examination (HR, 2.02; 95% CI, 1.80-2.26) and those with lower mammographic breast density (HR, 4.65; 95% CI, 2.61-8.29). In addition, breast cancer risk was higher for women who underwent a biopsy at the recall (HR, 1.77; 95% CI, 1.63-1.92) than for those without a biopsy (HR, 1.51; 95% CI, 1.43-1.60). Cancers after a false-positive result were more likely to be detected on the ipsilateral side of the false-positive result (HR, 1.92; 95% CI, 1.81-2.04) and were more common during the first 4 years of follow-up (HR, 2.57; 95% CI, 2.33-2.85 during the first 2 years; HR, 1.93; 95% CI, 1.76-2.12 at >2 to 4 years). No statistical difference was found for different tumor characteristics (except for larger tumor size). Furthermore, associated with the increased risk of breast cancer, women with a false-positive result had an 84% higher rate of breast cancer death than those without (HR, 1.84; 95% CI, 1.57-2.15). Conclusions and Relevance This study suggests that the risk of developing breast cancer after a false-positive mammography result differs by individual characteristics and follow-up. These findings can be used to develop individualized risk-based breast cancer screening after a false-positive result.
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Affiliation(s)
- Xinhe Mao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Chronic Disease Research Institute, the Children’s Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Keith Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Natalie Holowko
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Haomin Yang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - José Tapia
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Mao X, He W, Eriksson M, Lindström LS, Holowko N, Bajalica-Lagercrantz S, Hammarström M, Grassmann F, Humphreys K, Easton D, Hall P, Czene K. Prediction of breast cancer risk for sisters of women attending screening. J Natl Cancer Inst 2023; 115:1310-1317. [PMID: 37243694 PMCID: PMC10637039 DOI: 10.1093/jnci/djad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/17/2023] [Accepted: 05/23/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Risk assessment is important for breast cancer prevention and early detection. We aimed to examine whether common risk factors, mammographic features, and breast cancer risk prediction scores of a woman were associated with breast cancer risk for her sisters. METHODS We included 53 051 women from the Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA) study. Established risk factors were derived using self-reported questionnaires, mammograms, and single nucleotide polymorphism genotyping. Using the Swedish Multi-Generation Register, we identified 32 198 sisters of the KARMA women (including 5352 KARMA participants and 26 846 nonparticipants). Cox models were used to estimate the hazard ratios of breast cancer for both women and their sisters, respectively. RESULTS A higher breast cancer polygenic risk score, a history of benign breast disease, and higher breast density in women were associated with an increased risk of breast cancer for both women and their sisters. No statistically significant association was observed between breast microcalcifications and masses in women and breast cancer risk for their sisters. Furthermore, higher breast cancer risk scores in women were associated with an increased risk of breast cancer for their sisters. Specifically, the hazard ratios for breast cancer per 1 standard deviation increase in age-adjusted KARMA, Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA), and Tyrer-Cuzick risk scores were 1.16 (95% confidence interval [CI] = 1.07 to 1.27), 1.23 (95% CI = 1.12 to 1.35), and 1.21 (95% CI = 1.11 to 1.32), respectively. CONCLUSION A woman's breast cancer risk factors are associated with her sister's breast cancer risk. However, the clinical utility of these findings requires further investigation.
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Affiliation(s)
- Xinhe Mao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Chronic Disease Research Institute, The Children’s Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Linda S Lindström
- Department of Oncology-Pathology, Karolinska Institutet and Hereditary Cancer Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Natalie Holowko
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Svetlana Bajalica-Lagercrantz
- Department of Oncology-Pathology, Karolinska Institutet and Hereditary Cancer Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Mattias Hammarström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Felix Grassmann
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute for Clinical Research and Systems Medicine, Health and Medical University, Potsdam, Germany
| | - Keith Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Douglas Easton
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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10
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Anandarajah A, Chen Y, Stoll C, Hardi A, Jiang S, Colditz GA. Repeated measures of mammographic density and texture to evaluate prediction and risk of breast cancer: a systematic review of the methods used in the literature. Cancer Causes Control 2023; 34:939-948. [PMID: 37340148 PMCID: PMC10533570 DOI: 10.1007/s10552-023-01739-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 06/14/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE It may be important for women to have mammograms at different points in time to track changes in breast density, as fluctuations in breast density can affect breast cancer risk. This systematic review aimed to assess methods used to relate repeated mammographic images to breast cancer risk. METHODS The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov were searched through October 2021. Eligibility criteria included published articles in English describing the relationship of change in mammographic features with risk of breast cancer. Risk of bias was assessed using the Quality in Prognostic Studies tool. RESULTS Twenty articles were included. The Breast Imaging Reporting and Data System and Cumulus were most commonly used for classifying mammographic density and automated assessment was used on more recent digital mammograms. Time between mammograms varied from 1 year to a median of 4.1, and only nine of the studies used more than two mammograms. Several studies showed that adding change of density or mammographic features improved model performance. Variation in risk of bias of studies was highest in prognostic factor measurement and study confounding. CONCLUSION This review provided an updated overview and revealed research gaps in assessment of the use of texture features, risk prediction, and AUC. We provide recommendations for future studies using repeated measure methods for mammogram images to improve risk classification and risk prediction for women to tailor screening and prevention strategies to level of risk.
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Affiliation(s)
- Akila Anandarajah
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Yongzhen Chen
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Carolyn Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Angela Hardi
- Bernard Becker Medical Library, Washington University School of Medicine, MSC 8132-12-01, 660 S Euclid Ave, Saint Louis, MO, 63110, USA
| | - Shu Jiang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA.
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11
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Huang S, Xu JT, Yang M. Review: Predictive approaches to breast cancer risk. Heliyon 2023; 9:e21344. [PMID: 38034632 PMCID: PMC10685136 DOI: 10.1016/j.heliyon.2023.e21344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023] Open
Abstract
Despite the deployment of specific breast cancer screening strategies, breast cancer incidence rates have escalated significantly over recent decades. In a bid to reverse this trend, scientists have engaged in extensive epidemiological research into breast cancer prevalence, identifying numerous individual risk factors and promoting population-wide health education. Coupled with advances in genetic testing, risk prediction models based on breast cancer genes have been developed, albeit with inherent limitations. In the new millennium, the emergence of artificial intelligence (AI) as a dominant technological force suggests that breast cancer prediction models developed with AI may represent the next frontier in research.
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Affiliation(s)
- Shuai Huang
- Department of Breast Oncology, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
| | - Jun Tao Xu
- Joint Turing‐Darwin Laboratory of Phil Rivers Technology Ltd. and Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China Department of Computational Biology, Phil Rivers Technology Ltd, Beijing, China West Institute of Computing Technology, Chinese Academy of Sciences, Chongqing, China
| | - Mei Yang
- Department of Breast Oncology, Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
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12
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Shim S, Unkelbach J, Landsmann A, Boss A. Quantitative Study on the Breast Density and the Volume of the Mammary Gland According to the Patient's Age and Breast Quadrant. Diagnostics (Basel) 2023; 13:3343. [PMID: 37958239 PMCID: PMC10648521 DOI: 10.3390/diagnostics13213343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVES Breast density is considered an independent risk factor for the development of breast cancer. This study aimed to quantitatively assess the percent breast density (PBD) and the mammary glands volume (MGV) according to the patient's age and breast quadrant. We propose a regression model to estimate PBD and MGV as a function of the patient's age. METHODS The breast composition in 1027 spiral breast CT (BCT) datasets without soft tissue masses, calcifications, or implants from 517 women (57 ± 8 years) were segmented. The breast tissue volume (BTV), MGV, and PBD of the breasts were measured in the entire breast and each of the four quadrants. The three breast composition features were analyzed in the seven age groups, from 40 to 74 years in 5-year intervals. A logarithmic model was fitted to the BTV, and a multiplicative inverse model to the MGV and PBD as a function of age was established using a least-squares method. RESULTS The BTV increased from 545 ± 345 to 676 ± 412 cm3, and the MGV and PBD decreased from 111 ± 164 to 57 ± 43 cm3 and from 21 ± 21 to 11 ± 9%, respectively, from the youngest to the oldest group (p < 0.05). The average PBD over all ages were 14 ± 13%. The regression models could predict the BTV, MGV, and PBD based on the patient's age with residual standard errors of 386 cm3, 67 cm3, and 13%, respectively. The reduction in MGV and PBD in each quadrant followed the ones in the entire breast. CONCLUSIONS The PBD and MGV computed from BCT examinations provide important information for breast cancer risk assessment in women. The study quantified the breast mammary gland reduction and density decrease over the entire breast. It established mathematical models to estimate the breast composition features-BTV, MGV, and PBD, as a function of the patient's age.
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Affiliation(s)
- Sojin Shim
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (A.L.); (A.B.)
| | - Jan Unkelbach
- Department of Radiation Oncology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Anna Landsmann
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (A.L.); (A.B.)
| | - Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (A.L.); (A.B.)
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13
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Yan H, Ren W, Jia M, Xue P, Li Z, Zhang S, He L, Qiao Y. Breast cancer risk factors and mammographic density among 12518 average-risk women in rural China. BMC Cancer 2023; 23:952. [PMID: 37814233 PMCID: PMC10561452 DOI: 10.1186/s12885-023-11444-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Mammographic density (MD) is a strong risk factor for breast cancer. We aimed to evaluate the association between MD and breast cancer related risk factors among average-risk women in rural China. METHODS This is a population-based screening study. 12518 women aged 45-64 years with complete MD data from three maternal and childcare hospitals in China were included in the final analysis. ORs and 95%CIs were estimated using generalized logit model by comparing each higher MD (BI-RADS b, c, d) to the lowest group (BI-RADS a). The cumulative logistic regression model was used to estimate the ORtrend (95%CI) and Ptrend by treating MD as an ordinal variable. RESULTS Older age (ORtrend = 0.81, 95%CI: 0.79-0.81, per 2-year increase), higher BMI (ORtrend = 0.73, 95%CI: 0.71-0.75, per 2 kg/m2), more births (ORtrend = 0.47, 95%CI: 0.41-0.54, 3 + vs. 0-1), postmenopausal status (ORtrend = 0.42, 95%CI: 0.38-0.46) were associated with lower MD. For parous women, longer duration of breastfeeding was found to be associated with higher MD when adjusting for study site, age, BMI, and age of first full-term birth (ORtrend = 1.53, 95%CI: 1.27-1.85, 25 + months vs. no breastfeeding; ORtrend = 1.45, 95%CI: 1.20-1.75, 19-24 months vs. no breastfeeding), however, the association became non-significant when adjusting all covariates. Associations between examined risk factors and MD were similar in premenopausal and postmenopausal women except for level of education and oral hormone drug usage. Higher education was only found to be associated with an increased proportion of dense breasts in postmenopausal women (ORtrend = 1.08, 95%CI: 1.02-1.15). Premenopausal women who ever used oral hormone drug were less likely to have dense breasts, though the difference was marginally significant (OR = 0.54, P = 0.045). In postmenopausal women, we also found the proportion of dense breasts increased with age at menopause (ORtrend = 1.31, 95%CI: 1.21-1.43). CONCLUSIONS In Chinese women with average risk for breast cancer, we found MD was associated with age, BMI, menopausal status, lactation, and age at menopausal. This finding may help to understand the etiology of breast cancer and have implications for breast cancer prevention in China.
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Affiliation(s)
- Huijiao Yan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Wenhui Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Peng Xue
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Zhifang Li
- Changzhi Medical College, Changzhi, 046000, Shanxi, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, 450008, China
| | - Lichun He
- Mianyang Maternal & Child Health Care Hospital, Mianyang Children's Hospital, Mianyang, 621000, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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14
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Getz KR, Jeon MS, Luo C, Luo J, Toriola AT. Lipidome of mammographic breast density in premenopausal women. Breast Cancer Res 2023; 25:121. [PMID: 37814330 PMCID: PMC10561435 DOI: 10.1186/s13058-023-01725-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/02/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND High mammographic breast density (MBD) is a strong risk factor for breast cancer development, but the biological mechanisms underlying MBD are unclear. Lipids play important roles in cell differentiation, and perturbations in lipid metabolism are implicated in cancer development. Nevertheless, no study has applied untargeted lipidomics to profile the lipidome of MBD. Through this study, our goal is to characterize the lipidome of MBD in premenopausal women. METHODS Premenopausal women were recruited during their annual screening mammogram at the Washington University School of Medicine in St. Louis, MO. Untargeted lipidomic profiling for 982 lipid species was performed at Metabolon (Durham, NC®), and volumetric measures of MBD (volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV)) was assessed using Volpara 1.5 (Volpara Health®). We performed multivariable linear regression models to investigate the associations of lipid species with MBD and calculated the covariate-adjusted least square mean of MBD by quartiles of lipid species. MBD measures were log10 transformed, and lipid species were standardized. Linear coefficients of MBD were back-transformed and considered significant if the Bonferroni corrected p-value was < 0.05. RESULTS Of the 705 premenopausal women, 72% were non-Hispanic white, and 23% were non-Hispanic black. Mean age, and BMI were 46 years and 30 kg/m2, respectively. Fifty-six lipid species were significantly associated with VPD (52 inversely and 4 positively). The lipid species with positive associations were phosphatidylcholine (PC)(18:1/18:1), lysophosphatidylcholine (LPC)(18:1), lactosylceramide (LCER)(14:0), and phosphatidylinositol (PI)(18:1/18:1). VPD increased across quartiles of PI(18:1/18:1): (Q1 = 7.5%, Q2 = 7.7%, Q3 = 8.4%, Q4 = 9.4%, Bonferroni p-trend = 0.02). The lipid species that were inversely associated with VPD were mostly from the triacylglycerol (N = 43) and diacylglycerol (N = 7) sub-pathways. Lipid species explained some of the variation in VPD. The inclusion of lipid species increased the adjusted R2 from 0.45, for a model that includes known determinants of VPD, to 0.59. CONCLUSIONS We report novel lipid species that are associated with MBD in premenopausal women. Studies are needed to validate our results and the translational potential.
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Affiliation(s)
- Kayla R Getz
- Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University, 660 South Euclid Avenue, Box 8100, St. Louis, MO, 63110, USA
| | - Myung Sik Jeon
- Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University, 660 South Euclid Avenue, Box 8100, St. Louis, MO, 63110, USA
- Siteman Cancer Center Biostatistics Shared Resource, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Chongliang Luo
- Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University, 660 South Euclid Avenue, Box 8100, St. Louis, MO, 63110, USA
- Siteman Cancer Center Biostatistics Shared Resource, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingqin Luo
- Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University, 660 South Euclid Avenue, Box 8100, St. Louis, MO, 63110, USA
- Siteman Cancer Center Biostatistics Shared Resource, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University, 660 South Euclid Avenue, Box 8100, St. Louis, MO, 63110, USA.
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
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15
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Ho PJ, Lim EH, Hartman M, Wong FY, Li J. Breast cancer risk stratification using genetic and non-genetic risk assessment tools for 246,142 women in the UK Biobank. Genet Med 2023; 25:100917. [PMID: 37334786 DOI: 10.1016/j.gim.2023.100917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023] Open
Abstract
PURPOSE The benefit of using individual risk prediction tools to identify high-risk individuals for breast cancer (BC) screening is uncertain, despite the personalized approach of risk-based screening. METHODS We studied the overlap of predicted high-risk individuals among 246,142 women enrolled in the UK Biobank. Risk predictors assessed include the Gail model (Gail), BC family history (FH, binary), BC polygenic risk score (PRS), and presence of loss-of-function (LoF) variants in BC predisposition genes. Youden J-index was used to select optimal thresholds for defining high-risk. RESULTS In total, 147,399 were considered at high risk for developing BC within the next 2 years by at least 1 of the 4 risk prediction tools examined (Gail2-year > 0.5%: 47%, PRS2-yea r > 0.7%: 30%, FH: 6%, and LoF: 1%); 92,851 (38%) were flagged by only 1 risk predictor. The overlap between individuals flagged as high-risk because of genetic (PRS) and Gail model risk factors was 30%. The best-performing combinatorial model comprises a union of high-risk women identified by PRS, FH, and, LoF (AUC2-year [95% CI]: 62.2 [60.8 to 63.6]). Assigning individual weights to each risk prediction tool increased discriminatory ability. CONCLUSION Risk-based BC screening may require a multipronged approach that includes PRS, predisposition genes, FH, and other recognized risk factors.
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Affiliation(s)
- Peh Joo Ho
- Laboratory of Women's Health and Genetics, Genome Institute of Singapore, A∗STAR Research Entities, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Elaine H Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Department of Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jingmei Li
- Laboratory of Women's Health and Genetics, Genome Institute of Singapore, A∗STAR Research Entities, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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16
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Bell KJ, Brennan M. Does mammographic density predict survival in women with invasive breast cancer? The need to account for potential confounding from cancer stage and overdiagnosis. Breast 2023; 71:29-30. [PMID: 37467647 PMCID: PMC10372454 DOI: 10.1016/j.breast.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/21/2023] Open
Abstract
•The negative findings from the linked study suggest breast density may not affect prognosis after a breast cancer diagnosis. •Cancer stage and overdiagnosis are potential confounders of the relationship between breast density and health outcomes. •The prognostic value of changes in mammographic density over time may be explored in future research.
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Affiliation(s)
- Katy Jl Bell
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia.
| | - Meagan Brennan
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, Australia
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Bhimani F, Zhang J, Shah L, McEvoy M, Gupta A, Pastoriza J, Shihabi A, Feldman S. Can the Clinical Utility of iBreastExam, a Novel Device, Aid in Optimizing Breast Cancer Diagnosis? A Systematic Review. JCO Glob Oncol 2023; 9:e2300149. [PMID: 38085036 PMCID: PMC10846782 DOI: 10.1200/go.23.00149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/05/2023] [Accepted: 09/02/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE A portable, cost-effective, easy-to-use, hand-held Intelligent Breast Exam (iBE), which is a wireless, radiation-free device, may be a valuable screening tool in resource-limited settings. While multiple studies evaluating the use of iBE have been conducted worldwide, there are no cumulative studies evaluating the iBE's performance. Therefore this review aims to determine the clinical utility and applicability of iBE compared with clinical breast examinations, ultrasound, and mammography and discuss its strengths and weaknesses when performing breast-cancer screening. METHODS A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four electronic databases were searched: PubMed, Cochrane Library, Web of Science, and Google Scholar. RESULTS The review included 11 studies with a total sample size of 16,052 breasts. The mean age ranged from 42 to 58 years. The sensitivity and specificity of the iBE ranged from 34.3% to 86% and 59% to 94%, respectively. For malignant lesions, iBE demonstrated a moderate to higher diagnostic capacity ranging from 57% to 93% and could identify tumor sizes spanning from 0.5 cm to 9 cm. CONCLUSION Our findings underscore the potential clinical utility and applicability of iBE as a prescreening and triaging tool, which may aid in reducing the burden of patients undergoing diagnostic imaging in lower- and middle-income countries. Furthermore, iBE has shown to diagnose cancers as small as 0.5 cm, which can be a boon in early detection and reduce mortality rates. However, the encouraging results of this systematic review should be interpreted with caution because of the device's low sensitivity and high false-positive rates.
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Affiliation(s)
- Fardeen Bhimani
- Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, New York, NY
| | - Janice Zhang
- Albert Einstein College of Medicine, New York, NY
| | - Lamisha Shah
- Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, New York, NY
| | - Maureen McEvoy
- Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, New York, NY
| | - Anjuli Gupta
- Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, New York, NY
| | - Jessica Pastoriza
- Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, New York, NY
| | - Areej Shihabi
- Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, New York, NY
| | - Sheldon Feldman
- Breast Surgery Division, Department of Surgery, Montefiore Medical Center, Montefiore Einstein Center for Cancer Care, New York, NY
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18
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Janjic A, Akduman I, Cayoren M, Bugdayci O, Aribal ME. Microwave Breast Lesion Classification - Results from Clinical Investigation of the SAFE Microwave Breast Cancer System. Acad Radiol 2023; 30 Suppl 2:S1-S8. [PMID: 36549991 DOI: 10.1016/j.acra.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/22/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
RATIONALE AND OBJECTIVES Microwave breast cancer imaging (MWI) is an emerging non-invasive technology used to clinically assess the internal breast tissue inhomogeneity. MWI utilizes the variance in dielectric properties of healthy and cancerous tissue to identify anomalies inside the breast and make further clinical predictions. In this study, we evaluate our SAFE MWI system in a clinical setting. Capability of SAFE to provide breast pathology is assessed. MATERIALS AND METHODS Patients with BI-RADS category 4 or 5 who were scheduled for biopsy were included in the study. Machine learning approach, more specifically the Adaptive Boosting (AdaBoost) model, was implemented to determine if the level of difference between backscattered signals of breasts with the benign and malignant pathological outcome is significant enough for quantitative breast health classification via SAFE. RESULTS A dataset of 113 (70 benign and 43 malignant) breast samples was used in the study. The proposed classification model achieved the sensitivity, specificity, and accuracy of 79%, 77%, and 78%, respectively. CONCLUSION The non-ionizing and non-invasive nature gives SAFE an opportunity to impact breast cancer screening and early detection positively. Device classified both benign and malignant lesions at a similar rate. Further clinical studies are planned to validate the findings of this study.
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Affiliation(s)
- Aleksandar Janjic
- Mitos Medical Technologies, ITU Ayazaga Ari Teknokent, 2-B Block 2-2-E, Maslak 34469, Istanbul, Turkey; Electrical and Electronics Engineering Faculty, Istanbul Technical University, Maslak, 34469 Istanbul, Turkey.
| | - Ibrahim Akduman
- Mitos Medical Technologies, ITU Ayazaga Ari Teknokent, 2-B Block 2-2-E, Maslak 34469, Istanbul, Turkey; Electrical and Electronics Engineering Faculty, Istanbul Technical University, Maslak, 34469 Istanbul, Turkey
| | - Mehmet Cayoren
- Mitos Medical Technologies, ITU Ayazaga Ari Teknokent, 2-B Block 2-2-E, Maslak 34469, Istanbul, Turkey; Electrical and Electronics Engineering Faculty, Istanbul Technical University, Maslak, 34469 Istanbul, Turkey
| | - Onur Bugdayci
- Department of Radiology, School of Medicine, Marmara University, Pendik 34899, Istanbul, Turkey
| | - Mustafa Erkin Aribal
- Mitos Medical Technologies, ITU Ayazaga Ari Teknokent, 2-B Block 2-2-E, Maslak 34469, Istanbul, Turkey; Radiology Department, Breast Health Center, Altunizade Hospital, Acibadem M.A.A. University, Atasehir 34684, Istanbul, Turkey
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19
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Chen S, Tamimi RM, Colditz GA, Jiang S. Association and Prediction Utilizing Craniocaudal and Mediolateral Oblique View Digital Mammography and Long-Term Breast Cancer Risk. Cancer Prev Res (Phila) 2023; 16:531-537. [PMID: 37428020 PMCID: PMC10472097 DOI: 10.1158/1940-6207.capr-22-0499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 04/19/2023] [Accepted: 06/30/2023] [Indexed: 07/11/2023]
Abstract
Mammographic percentage of volumetric density is an important risk factor for breast cancer. Epidemiology studies historically used film images often limited to craniocaudal (CC) views to estimate area-based breast density. More recent studies using digital mammography images typically use the averaged density between craniocaudal (CC) and mediolateral oblique (MLO) view mammography for 5- and 10-year risk prediction. The performance in using either and both mammogram views has not been well-investigated. We use 3,804 full-field digital mammograms from the Joanne Knight Breast Health Cohort (294 incident cases and 657 controls), to quantity the association between volumetric percentage of density extracted from either and both mammography views and to assess the 5 and 10-year breast cancer risk prediction performance. Our results show that the association between percent volumetric density from CC, MLO, and the average between the two, retain essentially the same association with breast cancer risk. The 5- and 10-year risk prediction also shows similar prediction accuracy. Thus, one view is sufficient to assess association and predict future risk of breast cancer over a 5 or 10-year interval. PREVENTION RELEVANCE Expanding use of digital mammography and repeated screening provides opportunities for risk assessment. To use these images for risk estimates and guide risk management in real time requires efficient processing. Evaluating the contribution of different views to prediction performance can guide future applications for risk management in routine care.
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Affiliation(s)
- Simin Chen
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Rulla M. Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Graham A. Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | - Shu Jiang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
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20
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Habel LA, Alexeeff SE, Achacoso N, Arasu VA, Gastounioti A, Gerstley L, Klein RJ, Liang RY, Lipson JA, Mankowski W, Margolies LR, Rothstein JH, Rubin DL, Shen L, Sistig A, Song X, Villaseñor MA, Westley M, Whittemore AS, Yaffe MJ, Wang P, Kontos D, Sieh W. Examination of fully automated mammographic density measures using LIBRA and breast cancer risk in a cohort of 21,000 non-Hispanic white women. Breast Cancer Res 2023; 25:92. [PMID: 37544983 PMCID: PMC10405373 DOI: 10.1186/s13058-023-01685-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/09/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Breast density is strongly associated with breast cancer risk. Fully automated quantitative density assessment methods have recently been developed that could facilitate large-scale studies, although data on associations with long-term breast cancer risk are limited. We examined LIBRA assessments and breast cancer risk and compared results to prior assessments using Cumulus, an established computer-assisted method requiring manual thresholding. METHODS We conducted a cohort study among 21,150 non-Hispanic white female participants of the Research Program in Genes, Environment and Health of Kaiser Permanente Northern California who were 40-74 years at enrollment, followed for up to 10 years, and had archived processed screening mammograms acquired on Hologic or General Electric full-field digital mammography (FFDM) machines and prior Cumulus density assessments available for analysis. Dense area (DA), non-dense area (NDA), and percent density (PD) were assessed using LIBRA software. Cox regression was used to estimate hazard ratios (HRs) for breast cancer associated with DA, NDA and PD modeled continuously in standard deviation (SD) increments, adjusting for age, mammogram year, body mass index, parity, first-degree family history of breast cancer, and menopausal hormone use. We also examined differences by machine type and breast view. RESULTS The adjusted HRs for breast cancer associated with each SD increment of DA, NDA and PD were 1.36 (95% confidence interval, 1.18-1.57), 0.85 (0.77-0.93) and 1.44 (1.26-1.66) for LIBRA and 1.44 (1.33-1.55), 0.81 (0.74-0.89) and 1.54 (1.34-1.77) for Cumulus, respectively. LIBRA results were generally similar by machine type and breast view, although associations were strongest for Hologic machines and mediolateral oblique views. Results were also similar during the first 2 years, 2-5 years and 5-10 years after the baseline mammogram. CONCLUSION Associations with breast cancer risk were generally similar for LIBRA and Cumulus density measures and were sustained for up to 10 years. These findings support the suitability of fully automated LIBRA assessments on processed FFDM images for large-scale research on breast density and cancer risk.
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Affiliation(s)
- Laurel A Habel
- Division of Research, Kaiser Permanente Northern California, CA, Oakland, USA.
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, CA, Oakland, USA
| | - Ninah Achacoso
- Division of Research, Kaiser Permanente Northern California, CA, Oakland, USA
| | - Vignesh A Arasu
- Division of Research, Kaiser Permanente Northern California, CA, Oakland, USA
- Department of Radiology, Kaiser Permanente Northern California, Vallejo, CA, USA
| | - Aimilia Gastounioti
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Lawrence Gerstley
- Division of Research, Kaiser Permanente Northern California, CA, Oakland, USA
| | - Robert J Klein
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rhea Y Liang
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Jafi A Lipson
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Walter Mankowski
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Laurie R Margolies
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph H Rothstein
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Daniel L Rubin
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Li Shen
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, NY, New York, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana Sistig
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Xiaoyu Song
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Mark Westley
- Division of Research, Kaiser Permanente Northern California, CA, Oakland, USA
| | - Alice S Whittemore
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Martin J Yaffe
- Sunnybrook Research Institute and Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Pei Wang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Despina Kontos
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Weiva Sieh
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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21
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Jiang S, Bennett DL, Rosner BA, Colditz GA. Longitudinal Analysis of Change in Mammographic Density in Each Breast and Its Association With Breast Cancer Risk. JAMA Oncol 2023; 9:808-814. [PMID: 37103922 PMCID: PMC10141289 DOI: 10.1001/jamaoncol.2023.0434] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/27/2023] [Indexed: 04/28/2023]
Abstract
Importance Although breast density is an established risk factor for breast cancer, longitudinal changes in breast density have not been extensively studied to determine whether this factor is associated with breast cancer risk. Objective To prospectively evaluate the association between change in mammographic density in each breast over time and risk of subsequent breast cancer. Design, Setting, and Participants This nested case-control cohort study was sampled from the Joanne Knight Breast Health Cohort of 10 481 women free from cancer at entry and observed from November 3, 2008, to October 31, 2020, with routine screening mammograms every 1 to 2 years, providing a measure of breast density. Breast cancer screening was provided for a diverse population of women in the St Louis region. A total of 289 case patients with pathology-confirmed breast cancer were identified, and approximately 2 control participants were sampled for each case according to age at entry and year of enrollment, yielding 658 controls with a total number of 8710 craniocaudal-view mammograms for analysis. Exposures Exposures included screening mammograms with volumetric percentage of density, change in volumetric breast density over time, and breast biopsy pathology-confirmed cancer. Breast cancer risk factors were collected via questionnaire at enrollment. Main Outcomes and Measures Longitudinal changes over time in each woman's volumetric breast density by case and control status. Results The mean (SD) age of the 947 participants was 56.67 (8.71) years at entry; 141 were Black (14.9%), 763 were White (80.6%), 20 were of other race or ethnicity (2.1%), and 23 did not report this information (2.4%). The mean (SD) interval was 2.0 (1.5) years from last mammogram to date of subsequent breast cancer diagnosis (10th percentile, 1.0 year; 90th percentile, 3.9 years). Breast density decreased over time in both cases and controls. However, there was a significantly slower decrease in rate of decline in density in the breast that developed breast cancer compared with the decline in controls (estimate = 0.027; 95% CI, 0.001-0.053; P = .04). Conclusions and Relevance This study found that the rate of change in breast density was associated with the risk of subsequent breast cancer. Incorporation of longitudinal changes into existing models could optimize risk stratification and guide more personalized risk management.
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Affiliation(s)
- Shu Jiang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Debbie L. Bennett
- Department of Radiology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Bernard A. Rosner
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Graham A. Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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22
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Mao X, He W, Humphreys K, Eriksson M, Holowko N, Strand F, Hall P, Czene K. Factors Associated With False-Positive Recalls in Mammography Screening. J Natl Compr Canc Netw 2023; 21:143-152.e4. [PMID: 36791753 DOI: 10.6004/jnccn.2022.7081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/27/2022] [Indexed: 02/17/2023]
Abstract
BACKGROUND We aimed to identify factors associated with false-positive recalls in mammography screening compared with women who were not recalled and those who received true-positive recalls. METHODS We included 29,129 women, aged 40 to 74 years, who participated in the Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA) between 2011 and 2013 with follow-up until the end of 2017. Nonmammographic factors were collected from questionnaires, mammographic factors were generated from mammograms, and genotypes were determined using the OncoArray or an Illumina custom array. By the use of conditional and regular logistic regression models, we investigated the association between breast cancer risk factors and risk models and false-positive recalls. RESULTS Women with a history of benign breast disease, high breast density, masses, microcalcifications, high Tyrer-Cuzick 10-year risk scores, KARMA 2-year risk scores, and polygenic risk scores were more likely to have mammography recalls, including both false-positive and true-positive recalls. Further analyses restricted to women who were recalled found that women with a history of benign breast disease and dense breasts had a similar risk of having false-positive and true-positive recalls, whereas women with masses, microcalcifications, high Tyrer-Cuzick 10-year risk scores, KARMA 2-year risk scores, and polygenic risk scores were more likely to have true-positive recalls than false-positive recalls. CONCLUSIONS We found that risk factors associated with false-positive recalls were also likely, or even more likely, to be associated with true-positive recalls in mammography screening.
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Affiliation(s)
- Xinhe Mao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Wei He
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Chronic Disease Research Institute, the Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Keith Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Natalie Holowko
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Strand
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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23
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Song X, Ji J, Rothstein JH, Alexeeff SE, Sakoda LC, Sistig A, Achacoso N, Jorgenson E, Whittemore AS, Klein RJ, Habel LA, Wang P, Sieh W. MiXcan: a framework for cell-type-aware transcriptome-wide association studies with an application to breast cancer. Nat Commun 2023; 14:377. [PMID: 36690614 PMCID: PMC9871010 DOI: 10.1038/s41467-023-35888-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
Human bulk tissue samples comprise multiple cell types with diverse roles in disease etiology. Conventional transcriptome-wide association study approaches predict genetically regulated gene expression at the tissue level, without considering cell-type heterogeneity, and test associations of predicted tissue-level expression with disease. Here we develop MiXcan, a cell-type-aware transcriptome-wide association study approach that predicts cell-type-level expression, identifies disease-associated genes via combination of cell-type-level association signals for multiple cell types, and provides insight into the disease-critical cell type. As a proof of concept, we conducted cell-type-aware analyses of breast cancer in 58,648 women and identified 12 transcriptome-wide significant genes using MiXcan compared with only eight genes using conventional approaches. Importantly, MiXcan identified genes with distinct associations in mammary epithelial versus stromal cells, including three new breast cancer susceptibility genes. These findings demonstrate that cell-type-aware transcriptome-wide analyses can reveal new insights into the genetic and cellular etiology of breast cancer and other diseases.
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Affiliation(s)
- Xiaoyu Song
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Jiayi Ji
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Lori C Sakoda
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Adriana Sistig
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ninah Achacoso
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Eric Jorgenson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Regeneron Genetics Center, Tarrytown, NY, USA
| | - Alice S Whittemore
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Robert J Klein
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurel A Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Pei Wang
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Weiva Sieh
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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24
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Khorshid Shamshiri A, Alidoust M, Hemmati Nokandei M, Pasdar A, Afzaljavan F. Genetic architecture of mammographic density as a risk factor for breast cancer: a systematic review. CLINICAL & TRANSLATIONAL ONCOLOGY : OFFICIAL PUBLICATION OF THE FEDERATION OF SPANISH ONCOLOGY SOCIETIES AND OF THE NATIONAL CANCER INSTITUTE OF MEXICO 2023; 25:1729-1747. [PMID: 36639603 DOI: 10.1007/s12094-022-03071-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Mammography Density (MD) is a potential risk marker that is influenced by genetic polymorphisms and can subsequently modulate the risk of breast cancer. This qualitative systematic review summarizes the genes and biological pathways involved in breast density and discusses the potential clinical implications in view of the genetic risk profile for breast density. METHODS The terms related to "Common genetic variations" and "Breast density" were searched in Scopus, PubMed, and Web of Science databases. Gene pathways analysis and assessment of protein interactions were also performed. RESULTS Eighty-six studies including 111 genes, reported a significant association between mammographic density in different populations. ESR1, IGF1, IGFBP3, and ZNF365 were the most prevalent genes. Moreover, estrogen metabolism, signal transduction, and prolactin signaling pathways were significantly related to the associated genes. Mammography density was an associated phenotype, and eight out of 111 genes, including COMT, CYP19A1, CYP1B1, ESR1, IGF1, IGFBP1, IGFBP3, and LSP1, were modifiers of this trait. CONCLUSION Genes involved in developmental processes and the evolution of secondary sexual traits play an important role in determining mammographic density. Due to the effect of breast tissue density on the risk of breast cancer, these genes may also be associated with breast cancer risk.
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Affiliation(s)
- Asma Khorshid Shamshiri
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Alidoust
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboubeh Hemmati Nokandei
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Pasdar
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Division of Applied Medicine, Medical School, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
| | - Fahimeh Afzaljavan
- Clinical Research Development Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, 917794-8564, Iran.
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25
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Li J, Sun B, Li Y, Li S, Wang J, Zhu Y, Lu H. Correlation analysis between shear-wave elastography and pathological profiles in breast cancer. Breast Cancer Res Treat 2023; 197:269-276. [PMID: 36374375 DOI: 10.1007/s10549-022-06804-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To explore the correlation between shear-wave elastography (SWE) parameters and pathological profiles of invasive breast cancer. METHODS A total of 197 invasive breast cancers undergoing preoperative SWE and primary surgical treatment were included. Maximum elastic modulus (Emax), mean elastic modulus (Emean), and elastic modulus standard deviation (Esd) were calculated by SWE. Pathological profile was gold standard according to postoperative pathology. The relationship between SWE parameters and pathological factors were analyzed using univariate and multivariate analysis. RESULTS In univariate analysis, large cancers showed significantly higher Emax, Emean and Esd (all P < 0.001). Emax and Esd in the group of histological grade III were higher than those in the group of grade I (both P < 0.05). Invasive lobular carcinomas (ILC) showed higher Emean than invasive ductal carcinoma (IDC) (P < 0.001). Lymphovascular invasion (LVI) group showed higher Emax values than negative group (P < 0.05). Emax, Emean and Esd of the Ki-67 positive group presented higher values than negative group (all P < 0.05). Androgen receptor (AR) positive lesions had lower Esd than AR negative lesions (P < 0.05). In multivariate analysis, invasive size independently influenced Emax (P < 0.001). Invasive size and pathological type both independently influenced Emean (both P < 0.001). Invasive size and AR status were both independently influenced Esd (both P < 0.05). CONCLUSION SWE parameters correlated with pathological profiles of invasive breast cancer.In particular, AR positive group showed significantly low Esd than negative group.
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Affiliation(s)
- Junnan Li
- Department of Breast Imaging, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Bo Sun
- The Second Department of Breast Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yanbo Li
- Department of Breast Imaging, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Shuang Li
- Department of Bone and Tissue Oncology, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Jiahui Wang
- Department of Breast Imaging, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Ying Zhu
- Department of Breast Imaging, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Hong Lu
- Department of Breast Imaging, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. .,Tianjin Medical University Cancer Institute and Hospital, West Huan-Hu Rd, Ti Yuan Bei, Hexi District, Tianjin, 300060, People's Republic of China.
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New Confidence Intervals for Relative Risk of Two Correlated Proportions. STATISTICS IN BIOSCIENCES 2023; 15:1-30. [PMID: 35615750 PMCID: PMC9122488 DOI: 10.1007/s12561-022-09345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/17/2022] [Accepted: 04/23/2022] [Indexed: 11/08/2022]
Abstract
Biomedical studies, such as clinical trials, often require the comparison of measurements from two correlated tests in which each unit of observation is associated with a binary outcome of interest via relative risk. The associated confidence interval is crucial because it provides an appreciation of the spectrum of possible values, allowing for a more robust interpretation of relative risk. Of the available confidence interval methods for relative risk, the asymptotic score interval is the most widely recommended for practical use. We propose a modified score interval for relative risk and we also extend an existing nonparametric U-statistic-based confidence interval to relative risk. In addition, we theoretically prove that the original asymptotic score interval is equivalent to the constrained maximum likelihood-based interval proposed by Nam and Blackwelder. Two clinically relevant oncology trials are used to demonstrate the real-world performance of our methods. The finite sample properties of the new approaches, the current standard of practice, and other alternatives are studied via extensive simulation studies. We show that, as the strength of correlation increases, when the sample size is not too large the new score-based intervals outperform the existing intervals in terms of coverage probability. Moreover, our results indicate that the new nonparametric interval provides the coverage that most consistently meets or exceeds the nominal coverage probability.
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27
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Anandarajah A, Chen Y, Colditz GA, Hardi A, Stoll C, Jiang S. Studies of parenchymal texture added to mammographic breast density and risk of breast cancer: a systematic review of the methods used in the literature. Breast Cancer Res 2022; 24:101. [PMID: 36585732 PMCID: PMC9805242 DOI: 10.1186/s13058-022-01600-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
This systematic review aimed to assess the methods used to classify mammographic breast parenchymal features in relation to the prediction of future breast cancer. The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov were searched through October 2021 to extract published articles in English describing the relationship of parenchymal texture features with the risk of breast cancer. Twenty-eight articles published since 2016 were included in the final review. The identification of parenchymal texture features varied from using a predefined list to machine-driven identification. A reduction in the number of features chosen for subsequent analysis in relation to cancer incidence then varied across statistical approaches and machine learning methods. The variation in approach and number of features identified for inclusion in analysis precluded generating a quantitative summary or meta-analysis of the value of these features to improve predicting risk of future breast cancers. This updated overview of the state of the art revealed research gaps; based on these, we provide recommendations for future studies using parenchymal features for mammogram images to make use of accumulating image data, and external validation of prediction models that extend to 5 and 10 years to guide clinical risk management. Following these recommendations could enhance the applicability of models, helping improve risk classification and risk prediction for women to tailor screening and prevention strategies to the level of risk.
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Affiliation(s)
- Akila Anandarajah
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Yongzhen Chen
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Angela Hardi
- Bernard Becker Medical Library, Washington University School of Medicine, MSC 8132-12-01, 660 S Euclid Ave, Saint Louis, MO, 63110, USA
| | - Carolyn Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Shu Jiang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA.
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Gradient-Boosting Algorithm for Microwave Breast Lesion Classification-SAFE Clinical Investigation. Diagnostics (Basel) 2022; 12:diagnostics12123151. [PMID: 36553158 PMCID: PMC9777022 DOI: 10.3390/diagnostics12123151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/29/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
(1) Background: Microwave breast imaging (MBI) is a promising breast-imaging technology that uses harmless electromagnetic waves to radiate the breast and assess its internal structure. It utilizes the difference in dielectric properties of healthy and cancerous tissue, as well as the dielectric difference between different cancerous tissue types to identify anomalies inside the breast and make further clinical predictions. In this study, we evaluate the capability of our upgraded MBI device to provide breast tissue pathology. (2) Methods: Only patients who were due to undergo biopsy were included in the study. A machine learning (ML) approach, namely Gradient Boosting, was used to understand information from the frequency spectrum, collected via SAFE, and provide breast tissue pathology. (3) Results: A total of 54 patients were involved in the study: 29 of them had benign and 25 had malignant findings. SAFE acquired 20 true-positive, 24 true-negative, 4 false-positive and 4 false-negative findings, achieving the sensitivity, specificity and accuracy of 80%, 83% and 81%, respectively. (4) Conclusions: The use of harmless tissue radiation indicates that SAFE can be used to provide the breast pathology of women of any age without safety restrictions. Results indicate that SAFE is capable of providing breast pathology at a high rate, encouraging further clinical investigations.
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Bodewes F, van Asselt A, Dorrius M, Greuter M, de Bock G. Mammographic breast density and the risk of breast cancer: A systematic review and meta-analysis. Breast 2022; 66:62-68. [PMID: 36183671 PMCID: PMC9530665 DOI: 10.1016/j.breast.2022.09.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Mammographic density is a well-defined risk factor for breast cancer and having extremely dense breast tissue is associated with a one-to six-fold increased risk of breast cancer. However, it is questioned whether this increased risk estimate is applicable to current breast density classification methods. Therefore, the aim of this study was to further investigate and clarify the association between mammographic density and breast cancer risk based on current literature. METHODS Medline, Embase and Web of Science were systematically searched for articles published since 2013, that used BI-RADS lexicon 5th edition and incorporated data on digital mammography. Crude and maximally confounder-adjusted data were pooled in odds ratios (ORs) using random-effects models. Heterogeneity regarding breast cancer risks were investigated using I2 statistic, stratified and sensitivity analyses. RESULTS Nine observational studies were included. Having extremely dense breast tissue (BI-RADS density D) resulted in a 2.11-fold (95% CI 1.84-2.42) increased breast cancer risk compared to having scattered dense breast tissue (BI-RADS density B). Sensitivity analysis showed that when only using data that had adjusted for age and BMI, the breast cancer risk was 1.83-fold (95% CI 1.52-2.21) increased. Both results were statistically significant and homogenous. CONCLUSIONS Mammographic breast density BI-RADS D is associated with an approximately two-fold increased risk of breast cancer compared to having BI-RADS density B in general population women. This is a novel and lower risk estimate compared to previously reported and might be explained due to the use of digital mammography and BI-RADS lexicon 5th edition.
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Affiliation(s)
- F.T.H. Bodewes
- Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, HPC: FA40, PO Box 30.001, Groningen, 9700 RB, the Netherlands
| | - A.A. van Asselt
- Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, HPC: FA40, PO Box 30.001, Groningen, 9700 RB, the Netherlands
| | - M.D. Dorrius
- Department of Radiology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - M.J.W. Greuter
- Department of Radiology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - G.H. de Bock
- Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, HPC: FA40, PO Box 30.001, Groningen, 9700 RB, the Netherlands,Corresponding author.
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30
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Larroza A, Pérez-Benito FJ, Perez-Cortes JC, Román M, Pollán M, Pérez-Gómez B, Salas-Trejo D, Casals M, Llobet R. Breast Dense Tissue Segmentation with Noisy Labels: A Hybrid Threshold-Based and Mask-Based Approach. Diagnostics (Basel) 2022; 12:diagnostics12081822. [PMID: 36010173 PMCID: PMC9406546 DOI: 10.3390/diagnostics12081822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
Breast density assessed from digital mammograms is a known biomarker related to a higher risk of developing breast cancer. Supervised learning algorithms have been implemented to determine this. However, the performance of these algorithms depends on the quality of the ground-truth information, which expert readers usually provide. These expert labels are noisy approximations to the ground truth, as there is both intra- and inter-observer variability among them. Thus, it is crucial to provide a reliable method to measure breast density from mammograms. This paper presents a fully automated method based on deep learning to estimate breast density, including breast detection, pectoral muscle exclusion, and dense tissue segmentation. We propose a novel confusion matrix (CM)—YNet model for the segmentation step. This architecture includes networks to model each radiologist’s noisy label and gives the estimated ground-truth segmentation as well as two parameters that allow interaction with a threshold-based labeling tool. A multi-center study involving 1785 women whose “for presentation” mammograms were obtained from 11 different medical facilities was performed. A total of 2496 mammograms were used as the training corpus, and 844 formed the testing corpus. Additionally, we included a totally independent dataset from a different center, composed of 381 women with one image per patient. Each mammogram was labeled independently by two expert radiologists using a threshold-based tool. The implemented CM-Ynet model achieved the highest DICE score averaged over both test datasets (0.82±0.14) when compared to the closest dense-tissue segmentation assessment from both radiologists. The level of concordance between the two radiologists showed a DICE score of 0.76±0.17. An automatic breast density estimator based on deep learning exhibited higher performance when compared with two experienced radiologists. This suggests that modeling each radiologist’s label allows for better estimation of the unknown ground-truth segmentation. The advantage of the proposed model is that it also provides the threshold parameters that enable user interaction with a threshold-based tool.
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Affiliation(s)
- Andrés Larroza
- Instituto Tecnológico de la Informática, Universitat Politècnica de València, Camino de Vera, 46022 València, Spain; (F.J.P.-B.); (J.-C.P.-C.); (R.L.)
- Correspondence:
| | - Francisco Javier Pérez-Benito
- Instituto Tecnológico de la Informática, Universitat Politècnica de València, Camino de Vera, 46022 València, Spain; (F.J.P.-B.); (J.-C.P.-C.); (R.L.)
| | - Juan-Carlos Perez-Cortes
- Instituto Tecnológico de la Informática, Universitat Politècnica de València, Camino de Vera, 46022 València, Spain; (F.J.P.-B.); (J.-C.P.-C.); (R.L.)
| | - Marta Román
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim 25–29, 08003 Barcelona, Spain;
| | - Marina Pollán
- National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos, 5, 28029 Madrid, Spain; (M.P.); (B.P.-G.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Carlos III Institute of Health, Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos, 5, 28029 Madrid, Spain; (M.P.); (B.P.-G.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Carlos III Institute of Health, Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Dolores Salas-Trejo
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, 46022 València, Spain; (D.S.-T.); (M.C.)
- Centro Superior de Investigación en Salud Pública, CSISP, FISABIO, 46020 València, Spain
| | - María Casals
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, 46022 València, Spain; (D.S.-T.); (M.C.)
- Centro Superior de Investigación en Salud Pública, CSISP, FISABIO, 46020 València, Spain
| | - Rafael Llobet
- Instituto Tecnológico de la Informática, Universitat Politècnica de València, Camino de Vera, 46022 València, Spain; (F.J.P.-B.); (J.-C.P.-C.); (R.L.)
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Sajjad B, Farooqi N, Rehman B, Khalid IB, Urooj N, Sajjad S, Mumtaz A, Tariq T, Iqbal khan A, Parvaiz MA. Correlation of Breast Density Grade on Mammogram With Diagnosed Breast Cancer: A Retrospective Cross-Sectional Study. Cureus 2022; 14:e27028. [PMID: 35989768 PMCID: PMC9386336 DOI: 10.7759/cureus.27028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2022] [Indexed: 11/05/2022] Open
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Eslami B, Alipour S, Omranipour R, Naddafi K, Naghizadeh MM, Shamsipour M, Aryan A, Abedi M, Bayani L, Hassanvand MS. Air pollution exposure and mammographic breast density in Tehran, Iran: a cross-sectional study. Environ Health Prev Med 2022; 27:28. [PMID: 35786683 PMCID: PMC9283909 DOI: 10.1265/ehpm.22-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Air pollution is one of the major public health challenges in many parts of the world possibly has an association with breast cancer. However, the mechanism is still unclear. This study aimed to find an association between exposure to six criteria ambient air pollutants (PM2.5, PM10, SO2, NO2, O3, and CO) and mammographic breast density (MBD), as one of the strongest predictors for developing breast cancer, in women living in Tehran, Iran. METHODS Participants were selected from women attending two university hospitals for screening mammography from 2019 to 2021. Breast density was rated by two expert radiologists. Individual exposures to 3-year ambient air pollution levels at the residence were estimated. RESULTS The final analysis in 791 eligible women showed that low and high breast density was detected in 34.8 and 62.2 of participants, respectively. Logistic regression analysis after considering all possible confounding factors represented that an increase in each unit of NO2 (ppb) exposure was associated with an increased risk of breast density with an OR equal to 1.04 (95CI: 1.01 to 1.07). Furthermore, CO level was associated with a decreasing breast density (OR = 0.40, 95CI = 0.19 to 0.86). None of the other pollutants were associated with breast density. CONCLUSION Higher MBD was associated with an increased level of NO2, as a marker of traffic-related air pollution. Furthermore, CO concentration was associated with a lower MBD, while other criteria air pollutants were not related to MBD. Further studies are needed to evaluate the association between ambient air pollutants with MBD.
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Affiliation(s)
- Bita Eslami
- Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Science
| | - Sadaf Alipour
- Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Science.,Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences
| | - Ramesh Omranipour
- Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Science.,Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences
| | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences.,Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences
| | | | - Mansour Shamsipour
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences.,Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences
| | - Arvin Aryan
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences
| | - Mahboubeh Abedi
- Department of Radiology, Arash Women's Hospital, Tehran University of Medical Sciences
| | - Leila Bayani
- Department of Radiology, Arash Women's Hospital, Tehran University of Medical Sciences
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences.,Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences
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Body Mass Index Is Inversely Associated with Risk of Postmenopausal Interval Breast Cancer: Results from the Women’s Health Initiative. Cancers (Basel) 2022; 14:cancers14133228. [PMID: 35804998 PMCID: PMC9264843 DOI: 10.3390/cancers14133228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023] Open
Abstract
Interval breast cancer refers to cancer diagnosed after a negative screening mammogram and before the next scheduled screening mammogram. Interval breast cancer has worse prognosis than screening-detected cancer. Body mass index (BMI) influences the accuracy of mammography and overall postmenopausal breast cancer risk, yet how is obesity associated with postmenopausal interval breast cancer incidence is unclear. The current study included cancer-free postmenopausal women aged 50–79 years at enrollment in the Women’s Health Initiative who were diagnosed with breast cancer during follow-up. Analyses include 324 interval breast cancer cases diagnosed within one year after the participant’s last negative screening mammogram and 1969 screening-detected breast cancer patients. Obesity (BMI ≥ 30 kg/m2) was measured at baseline. Associations between obesity and incidence of interval cancer were determined by sequential logistic regression analyses. In multivariable-adjusted models, obesity was inversely associated with interval breast cancer risk [OR (95% CI) = 0.65 (0.46, 0.92)]. The inverse association persisted after excluding women diagnosed within 2 years [OR (95% CI) = 0.60 (0.42, 0.87)] or 4 years [OR (95% CI) = 0.56 (0.37, 0.86)] of enrollment, suggesting consistency of the association regardless of screening practices prior to trial entry. These findings warrant confirmation in studies with body composition measures.
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Pizzato M, Carioli G, Rosso S, Zanetti R, La Vecchia C. Mammographic breast density and survival in women with invasive breast cancer. Cancer Causes Control 2022; 33:1207-1213. [PMID: 35696000 DOI: 10.1007/s10552-022-01590-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/09/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE We explored the under-debate association between mammographic breast density (MBD) and survival. METHODS From the Piedmont Cancer Registry, we identified 693 invasive breast cancer (BC) cases. We analyzed the overall survival in strata of MBD through the Kaplan-Meier method. Using the Cox proportional hazards model, we estimated the hazard ratios (HRs) of death; using the cause-specific hazards regression model, we estimated the HRs of BC-related and other causes of death. Models included term for Breast Imaging-Reporting and Data System (BI-RADS) MBD (categorized as BI-RADS 1 and BI-RADS 2-4) and were adjusted for selected patient and tumour characteristics. RESULTS There were 102 deaths, of which 49 were from BC. After 5 years, the overall survival was 69% in BI-RADS 1 and 88% in BI-RADS 2-4 (p < 0.01). Compared to BI-RADS 2-4, the HRs of death for BI-RADS 1 were 1.65 (95% CI 1.06-2.58) in the crude model and 1.35 (95% CI 0.84-2.16) in the fully adjusted model. Compared to BI-RADS 2-4, the fully adjusted HRs for BI-RADS 1 were 1.52 (95% CI 0.74-3.13) for BC-related death and 1.83 (95% CI 0.84-4.00) for the other causes of death. CONCLUSION Higher MBD is one of the strongest independent risk factors for BC, but it seems not to have an unfavorable impact on survival.
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Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community Health, University of Milan, Via Celoria 22, 20133, Milan, Italy
| | - Greta Carioli
- Department of Clinical Sciences and Community Health, University of Milan, Via Celoria 22, 20133, Milan, Italy.
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U, Citta` della Salute e della Scienza di Torino, Turin, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, A.O.U, Citta` della Salute e della Scienza di Torino, Turin, Italy.,Fondo Elena Moroni for Oncology, Turin, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Via Celoria 22, 20133, Milan, Italy
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Sneider A, Kiemen A, Kim JH, Wu PH, Habibi M, White M, Phillip JM, Gu L, Wirtz D. Deep learning identification of stiffness markers in breast cancer. Biomaterials 2022; 285:121540. [PMID: 35537336 PMCID: PMC9873266 DOI: 10.1016/j.biomaterials.2022.121540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 02/07/2023]
Abstract
While essential to our understanding of solid tumor progression, the study of cell and tissue mechanics has yet to find traction in the clinic. Determining tissue stiffness, a mechanical property known to promote a malignant phenotype in vitro and in vivo, is not part of the standard algorithm for the diagnosis and treatment of breast cancer. Instead, clinicians routinely use mammograms to identify malignant lesions and radiographically dense breast tissue is associated with an increased risk of developing cancer. Whether breast density is related to tumor tissue stiffness, and what cellular and non-cellular components of the tumor contribute the most to its stiffness are not well understood. Through training of a deep learning network and mechanical measurements of fresh patient tissue, we create a bridge in understanding between clinical and mechanical markers. The automatic identification of cellular and extracellular features from hematoxylin and eosin (H&E)-stained slides reveals that global and local breast tissue stiffness best correlate with the percentage of straight collagen. Importantly, the percentage of dense breast tissue does not directly correlate with tissue stiffness or straight collagen content.
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Affiliation(s)
- Alexandra Sneider
- Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Ashley Kiemen
- Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Joo Ho Kim
- Department of Materials Science and Engineering, Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Pei-Hsun Wu
- Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Mehran Habibi
- Johns Hopkins Breast Center, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD, 21224, USA
| | - Marissa White
- Department of Pathology, Johns Hopkins School of Medicine, 401 N Broadway, Baltimore, MD, 21231, USA
| | - Jude M. Phillip
- Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA,Department of Biomedical Engineering, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Luo Gu
- Department of Materials Science and Engineering, Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA
| | - Denis Wirtz
- Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA,Department of Pathology, Johns Hopkins School of Medicine, 401 N Broadway, Baltimore, MD, 21231, USA,Department of Oncology, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD, 21205, USA,Corresponding author. Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, and Institute for NanoBioTechnology, Johns Hopkins University, 3400 N Charles St, Baltimore, MD, 21218, USA., (D. Wirtz)
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Chikarmane S. Synthetic Mammography: Review of Benefits and Drawbacks in Clinical Use. JOURNAL OF BREAST IMAGING 2022; 4:124-134. [PMID: 38417004 DOI: 10.1093/jbi/wbac008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Indexed: 03/01/2024]
Abstract
Digital breast tomosynthesis (DBT) has been widely adopted as a breast cancer screening tool, demonstrating decreased recall rates and other improved screening performance metrics when compared to digital mammography (DM) alone. Drawbacks of DBT when added to 2D DM include the increased radiation dose and longer examination time. Synthetic mammography (SM), a 2D reconstruction from the tomosynthesis slices, has been introduced to eliminate the need for a separate acquisition of 2D DM. Data show that the replacement of 2D DM by SM, when used with DBT, maintains the benefits of DBT, such as decreased recall rates, improved cancer detection rates, and similar positive predictive values. Key differences between SM and 2D DM include how the image is acquired, assessment of breast density, and visualization of mammographic findings, such as calcifications. Although SM is approved by the Food and Drug Administration and has been shown to be non-inferior when used with DBT, concerns surrounding SM include image quality and artifacts. The purpose of this review article is to review the benefits, drawbacks, and screening performance metrics of SM versus DBT.
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Affiliation(s)
- Sona Chikarmane
- Brigham and Women's Hospital, Department of Radiology, Boston, MA, USA
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37
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Mintz R, Wang M, Xu S, Colditz GA, Markovic C, Toriola AT. Hormone and receptor activator of NF-κB (RANK) pathway gene expression in plasma and mammographic breast density in postmenopausal women. Breast Cancer Res 2022; 24:28. [PMID: 35422057 PMCID: PMC9008951 DOI: 10.1186/s13058-022-01522-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/27/2022] [Indexed: 12/22/2022] Open
Abstract
Background Hormones impact breast tissue proliferation. Studies investigating the associations of circulating hormone levels with mammographic breast density have reported conflicting results. Due to the limited number of studies, we investigated the associations of hormone gene expression as well as their downstream mediators within the plasma with mammographic breast density in postmenopausal women. Methods We recruited postmenopausal women at their annual screening mammogram at Washington University School of Medicine, St. Louis. We used the NanoString nCounter platform to quantify gene expression of hormones (prolactin, progesterone receptor (PGR), estrogen receptor 1 (ESR1), signal transducer and activator of transcription (STAT1 and STAT5), and receptor activator of nuclear factor-kB (RANK) pathway markers (RANK, RANKL, osteoprotegerin, TNFRSF18, and TNFRSF13B) in plasma. We used Volpara to measure volumetric percent density, dense volume, and non-dense volume. Linear regression models, adjusted for confounders, were used to evaluate associations between gene expression (linear fold change) and mammographic breast density. Results One unit increase in ESR1, RANK, and TNFRSF18 gene expression was associated with 8% (95% CI 0–15%, p value = 0.05), 10% (95% CI 0–20%, p value = 0.04) and % (95% CI 0–9%, p value = 0.04) higher volumetric percent density, respectively. There were no associations between gene expression of other markers and volumetric percent density. One unit increase in osteoprotegerin and PGR gene expression was associated with 12% (95% CI 4–19%, p value = 0.003) and 7% (95% CI 0–13%, p value = 0.04) lower non-dense volume, respectively. Conclusion These findings provide new insight on the associations of plasma hormonal and RANK pathway gene expression with mammographic breast density in postmenopausal women and require confirmation in other studies. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-022-01522-2.
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Affiliation(s)
- Rachel Mintz
- Biomedical Engineering Department, Washington University, St. Louis, MO, 63110, USA
| | - Mei Wang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Campus Box 8100, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Shuai Xu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Campus Box 8100, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Campus Box 8100, 660 South Euclid Ave, St. Louis, MO, 63110, USA.,Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA
| | - Chris Markovic
- McDonnell Genome Institute at Washington University, St. Louis, MO, 63018, USA
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Campus Box 8100, 660 South Euclid Ave, St. Louis, MO, 63110, USA. .,Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA.
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38
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BOLAT H, ERDOĞAN A. Relationship of blood 25-hydroxy vitamin D level with fibrocystic breast disease and breast density. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1016601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Park CKS, Xing S, Papernick S, Orlando N, Knull E, Toit CD, Bax JS, Gardi L, Barker K, Tessier D, Fenster A. Spatially tracked whole-breast three-dimensional ultrasound system toward point-of-care breast cancer screening in high-risk women with dense breasts. Med Phys 2022; 49:3944-3962. [PMID: 35319105 DOI: 10.1002/mp.15632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Mammographic screening has reduced mortality in women through the early detection of breast cancer. However, the sensitivity for breast cancer detection is significantly reduced in women with dense breasts, in addition to being an independent risk factor. Ultrasound (US) has been proven effective in detecting small, early-stage, and invasive cancers in women with dense breasts. PURPOSE To develop an alternative, versatile, and cost-effective spatially tracked three-dimensional (3D) US system for whole-breast imaging. This paper describes the design, development, and validation of the spatially tracked 3DUS system, including its components for spatial tracking, multi-image registration and fusion, feasibility for whole-breast 3DUS imaging and multi-planar visualization in tissue-mimicking phantoms, and a proof-of-concept healthy volunteer study. METHODS The spatially tracked 3DUS system contains (a) a six-axis manipulator and counterbalanced stabilizer, (b) an in-house quick-release 3DUS scanner, adaptable to any commercially available US system, and removable, allowing for handheld 3DUS acquisition and two-dimensional US imaging, and (c) custom software for 3D tracking, 3DUS reconstruction, visualization, and spatial-based multi-image registration and fusion of 3DUS images for whole-breast imaging. Spatial tracking of the 3D position and orientation of the system and its joints (J1-6 ) were evaluated in a clinically accessible workspace for bedside point-of-care (POC) imaging. Multi-image registration and fusion of acquired 3DUS images were assessed with a quadrants-based protocol in tissue-mimicking phantoms and the target registration error (TRE) was quantified. Whole-breast 3DUS imaging and multi-planar visualization were evaluated with a tissue-mimicking breast phantom. Feasibility for spatially tracked whole-breast 3DUS imaging was assessed in a proof-of-concept healthy male and female volunteer study. RESULTS Mean tracking errors were 0.87 ± 0.52, 0.70 ± 0.46, 0.53 ± 0.48, 0.34 ± 0.32, 0.43 ± 0.28, and 0.78 ± 0.54 mm for joints J1-6 , respectively. Lookup table (LUT) corrections minimized the error in joints J1 , J2 , and J5 . Compound motions exercising all joints simultaneously resulted in a mean tracking error of 1.08 ± 0.88 mm (N = 20) within the overall workspace for bedside 3DUS imaging. Multi-image registration and fusion of two acquired 3DUS images resulted in a mean TRE of 1.28 ± 0.10 mm. Whole-breast 3DUS imaging and multi-planar visualization in axial, sagittal, and coronal views were demonstrated with the tissue-mimicking breast phantom. The feasibility of the whole-breast 3DUS approach was demonstrated in healthy male and female volunteers. In the male volunteer, the high-resolution whole-breast 3DUS acquisition protocol was optimized without the added complexities of curvature and tissue deformations. With small post-acquisition corrections for motion, whole-breast 3DUS imaging was performed on the healthy female volunteer showing relevant anatomical structures and details. CONCLUSIONS Our spatially tracked 3DUS system shows potential utility as an alternative, accurate, and feasible whole-breast approach with the capability for bedside POC imaging. Future work is focused on reducing misregistration errors due to motion and tissue deformations, to develop a robust spatially tracked whole-breast 3DUS acquisition protocol, then exploring its clinical utility for screening high-risk women with dense breasts.
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Affiliation(s)
- Claire Keun Sun Park
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - Shuwei Xing
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada.,School of Biomedical Engineering, Faculty of Engineering, Western University, London, Ontario, Canada
| | - Samuel Papernick
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - Nathan Orlando
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - Eric Knull
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada.,School of Biomedical Engineering, Faculty of Engineering, Western University, London, Ontario, Canada
| | - Carla Du Toit
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada.,School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Jeffrey Scott Bax
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - Lori Gardi
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - Kevin Barker
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - David Tessier
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - Aaron Fenster
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada.,School of Biomedical Engineering, Faculty of Engineering, Western University, London, Ontario, Canada.,Division of Imaging Sciences, Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Lee S, Kim H, Lee H, Cho S. Deep-learning-based projection-domain breast thickness estimation for shape-prior iterative image reconstruction in digital breast tomosynthesis. Med Phys 2022; 49:3670-3682. [PMID: 35297075 DOI: 10.1002/mp.15612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Digital breast tomosynthesis (DBT) is a technique that can overcome the shortcomings of conventional X-ray mammography and can be effective for the early screening of breast cancer. The compression of the breast is essential during the DBT imaging. However, since the periphery of the breast cannot be compressed to a constant value, nonuniformity of thickness and in-plane shape variation happen. These cause inconvenience in diagnosis, scatter correction, and breast density estimation. PURPOSE In this study, we propose a deep-learning-based methodology for projection-domain breast thickness estimation and demonstrate a shape-prior iterative DBT image reconstruction. METHODS We prepared the Euclidean distance map, the thickness map, and the thickness corrected image of the simulated breast projections for thickness and shape estimation. Each pixel of the Euclidean distance map denotes a distance to the closest skin-line. The thickness map is defined as a conceptual projection of ideal breast support that differentiates the inner and outer regions of the breast phantom. The thickness projection map thus represents the x-ray path lengths of a homogeneous breast phantom. We generated the thickness corrected image by dividing the projection image by the thickness map in a pixel-wise manner. We developed a convolutional neural network for thickness estimation and correction. The network utilizes a projection image and a Euclidean distance image together as a dual input. An estimated breast thickness map is then used for constructing the breast shape mask by use of the discrete algebraic reconstruction technique (DART). RESULTS The proposed network effectively corrected the breast thickness in various simulation situations. Low normalized root-mean-squared error (NRMSE; 1.976%) and high structural similarity (SSIM; 99.997%) indicated a good agreement between the network-generated thickness corrected image and the ground-truth image. Compared to the existing methods and simple single-input network, the proposed method showed outperformance in breast thickness estimation and accordingly in breast shape recovery for various numerical phantoms without provoking any significant artifact. We have demonstrated that the uniformity of voxel value has improved by the inclusion of a shape-prior for the iterative DBT reconstruction. CONCLUSIONS We presented a novel deep-learning-based breast thickness correction and a shape reconstruction method. This approach to estimating the true thickness map and the shape of the breast undergoing compression can benefit various fields such as improvement of diagnostic breast images, scatter correction, material decomposition, and breast density estimation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Seoyoung Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Hyeongseok Kim
- KAIST Institute for Artificial Intelligence, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Hoyeon Lee
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, 02114, USA
| | - Seungryong Cho
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea.,KAIST Institute for Artificial Intelligence, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea.,KAIST Institutes for IT Convergence and Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
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41
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Akinjiyan FA, Adams A, Xu S, Wang M, Toriola AT. Plasma Growth Factor Gene Expression and Mammographic Breast Density in Postmenopausal Women. Cancer Prev Res (Phila) 2022; 15:391-398. [PMID: 35288741 DOI: 10.1158/1940-6207.capr-21-0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/28/2021] [Accepted: 03/11/2022] [Indexed: 11/16/2022]
Abstract
Mammographic breast density (MBD) is a risk factor for breast cancer, but its molecular basis is poorly understood. Growth factors stimulate cellular and epithelial proliferation and could influence MBD via these mechanisms. Studies investigating the associations of circulating growth factors with MBD have, however, yielded conflicting results especially in postmenopausal women. We, therefore, investigated the associations of plasma growth factor gene expression (IGF-1, IGFBP-3, FGF-1, FGF-12, TGFB-1 and BMP-2) with MBD in postmenopausal women. We used NanoString nCounter platform to quantify plasma growth factor gene expression and Volpara to evaluate volumetric MBD measures. We investigated the associations of growth factor gene expression with MBD using both multiple linear regression (fold change) and multinomial logistic regression models, adjusted for potential confounders. The mean age of the 368 women enrolled was 58 years (range: 50-64). In analyses using linear regression models, one unit increase in IGF-1 gene expression was associated with a 35% higher VPD (1.35, 95%CI 1.13-1.60, p-value=0.001). There were suggestions that TGFB-1 gene expression was positively associated with VPD while BMP gene expression was inversely associated with VPD, but these were not statistically significant. In analyses using multinomial logistic regression, TGFB-1 gene expression was 33% higher (OR=1.33, 95%CI 1.13-1.56, p-value=0.0008) in women with extremely dense breasts than those with almost entirely fatty breasts. There were no associations between growth factor gene expression and dense volume or non-dense volume. Our study provides insights into the associations of growth factors with MBD in postmenopausal women and require confirmation in other study populations.
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Affiliation(s)
- Favour A Akinjiyan
- Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States
| | - Andrea Adams
- Washington University in St. Louis School of Medicine, St. Louis, United States
| | - Shuai Xu
- Washington University in St. Louis School of Medicine, Saint Louis, United States
| | - Mei Wang
- Washington University in St. Louis School of Medicine, St. Louis, United States
| | - Adetunji T Toriola
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
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Flugelman AA, Burton A, Keinan‐Boker L, Stein N, Kutner D, Shemesh L, Boyd N. Correlation between cumulative mammographic density and age ‐ specific incidence of breast cancer: a bi‐ethnic study in israel. Int J Cancer 2022; 150:1968-1977. [DOI: 10.1002/ijc.33957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/08/2022] [Accepted: 01/18/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Anath A. Flugelman
- From Rambam Health Care Campus Technion‐Israel Institute of Technology Haifa Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion‐Israel Institute of Technology Haifa Israel
| | - Anya Burton
- National Cancer Registration and Analysis Service Bristol UK
| | - Lital Keinan‐Boker
- National Cancer Registry Center for Disease Control, Ministry of Health Ramat Gan
- School of Public Health University of Haifa Haifa Israel
| | - Nili Stein
- The Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center
- Clalit National Cancer Control Center Haifa Israel
| | - Dafna Kutner
- The Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center
- Clalit National Cancer Control Center Haifa Israel
| | - Lior Shemesh
- The Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center
- Clalit National Cancer Control Center Haifa Israel
| | - Norman Boyd
- Princess Margaret Cancer Center Toronto Ontario Canada
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Han Y, Moore JX, Colditz GA, Toriola AT. Family History of Breast Cancer and Mammographic Breast Density in Premenopausal Women. JAMA Netw Open 2022; 5:e2148983. [PMID: 35175341 PMCID: PMC8855232 DOI: 10.1001/jamanetworkopen.2021.48983] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/28/2021] [Indexed: 11/14/2022] Open
Abstract
Importance Family history of breast cancer (FHBC) and mammographic breast density are independent risk factors for breast cancer, but the association of FHBC and mammographic breast density in premenopausal women is not well understood. Objectives To investigate the association of FHBC and mammographic breast density in premenopausal women using both quantitative and qualitative measurements. Design, Setting, and Participants This single-center cohort study examined 2 retrospective cohorts: a discovery set of 375 premenopausal women and a validation set of 14 040 premenopausal women. Data from women in the discovery set was collected between December 2015 and October 2016, whereas data from women in the validation set was collected between June 2010 and December 2015. Data analysis was performed between June 2018 and June 2020. Exposures Family history of breast cancer (FHBC). Main Outcomes and Measures The primary outcomes were mammographic breast density measured quantitatively as volumetric percent density using Volpara (discovery set) and qualitatively using BI-RADS (Breast Imaging Reporting and Data System) breast density (validation set). Multivariable regressions were performed using a log-transformed normal distribution for the discovery set and a logistic distribution for the validation set. Results Of 14 415 premenopausal women included in the study, the discovery set and validation set had similar characteristics (discovery set with FHBC: mean [SD] age, 47.1 [5.6] years; 15 [17.2%] were Black or African American women and 64 [73.6%] were non-Hispanic White women; discovery set with no FHBC: mean [SD] age, 47.7 [4.5] years; 87 [31.6%] were Black or African American women and 178 [64.7%] were non-Hispanic White women; validation set with FHBC: mean [SD] age, 46.8 [7.3] years; 720 [33.4%] were Black or African American women and 1378 [64.0%] were non-Hispanic White women]; validation set with no FHBC: mean [SD] age, 47.5 [6.1] years; 4572 [38.5%] were Black or African American women and 6632 [55.8%] were non-Hispanic White women]). In the discovery set, participants who had FHBC were more likely to have a higher mean volumetric percent density compared with participants with no FHBC (11.1% vs 9.0%). In the multivariable-adjusted model, volumetric percent density was 25% higher (odds ratio [OR], 1.25 ;95% CI, 1.12-1.41) in women with FHBC compared with women without FHBC; and 24% higher (OR, 1.24; 95% CI, 1.10-1.40) in women who had 1 affected relative, but not significantly higher in women who had at least 2 affected relatives (OR, 1.40; 95% CI, 0.95-2.07) compared with women with no relatives affected. In the validation set, women with a positive FHBC were more likely to have dense breasts (BI-RADS 3-4) compared with women with no FHBC (BI-RADS 3: 41.1% vs 38.8%; BI-RADS 4: 10.5% vs 7.7%). In the multivariable-adjusted model, the odds of having dense breasts (BI-RADS 3-4) were 30% higher (OR, 1.30; 95% CI, 1.17-1.45) in women with FHBC compared with women without FHBC; and 29% higher (OR, 1.29; 95% CI, 1.14-1.45) in women who had 1 affected relative, but not significantly higher in women who had at least 2 affected relatives (OR, 1.38; 95% CI, 0.85-2.23) compared with women with no relatives affected. Conclusions and Relevance In this cohort study, having an FHBC was positively associated with mammographic breast density in premenopausal women. Our findings highlight the heritable component of mammographic breast density and underscore the need to begin annual screening early in premenopausal women with a family history of breast cancer.
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Affiliation(s)
- Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Justin Xavier Moore
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Augusta University, Augusta, Georgia
| | - Graham A. Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | - Adetunji T. Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
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Saghatchian M, Abehsera M, Yamgnane A, Geyl C, Gauthier E, Hélin V, Bazire M, Villoing-Gaudé L, Reyes C, Gentien D, Golmard L, Stoppa-Lyonnet D. Feasibility of personalized screening and prevention recommendations in the general population through breast cancer risk assessment: results from a dedicated risk clinic. Breast Cancer Res Treat 2022; 192:375-383. [PMID: 34994879 PMCID: PMC8739506 DOI: 10.1007/s10549-021-06445-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/08/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE A personalized approach to prevention and early detection based on known risk factors should contribute to early diagnosis and treatment of breast cancer. We initiated a risk assessment clinic for all women wishing to undergo an individual breast cancer risk assessment. METHODS Women underwent a complete breast cancer assessment including a questionnaire, mammogram with evaluation of breast density, collection of saliva sample, consultation with a radiologist, and a breast cancer specialist. Women aged 40 or older, with 0 or 1 first-degree relative with breast cancer diagnosed after the age of 40 were eligible for risk assessment using MammoRisk, a machine learning-based tool that provides an individual 5-year estimated risk of developing breast cancer based on the patient's clinical data and breast density, with or without polygenic risk scores (PRSs). DNA was extracted from saliva samples for genotyping of 76 single-nucleotide polymorphisms. The individual risk was communicated to the patient, with individualized screening and prevention recommendations. RESULTS A total of 290 women underwent breast cancer assessment, among which 196 women (68%) were eligible for risk assessment using MammoRisk (median age 52, range 40-72). When PRS was added to MammoRisk, 40% (n = 78) of patients were assigned a different risk category, with 28% (n = 55) of patients changing from intermediate to moderate or high risk. CONCLUSION Individual risk assessment is feasible in the general population. Screening recommendations could be given based on individual risk. The use of PRS changed the risk score and screening recommendations in 40% of women.
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Affiliation(s)
- Mahasti Saghatchian
- American Hospital of Paris, Neuilly-sur-Seine, France. .,Paris-Descartes University, Paris, France.
| | - Marc Abehsera
- American Hospital of Paris, Neuilly-sur-Seine, France
| | | | - Caroline Geyl
- American Hospital of Paris, Neuilly-sur-Seine, France
| | | | | | | | | | | | | | - Lisa Golmard
- INSERM U830 D.R.U.M. Team, Institut Curie Hospital, Paris-University, Paris, France
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Paris, France.,INSERM U830 D.R.U.M. Team, Institut Curie Hospital, Paris-University, Paris, France
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Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities. Curr Environ Health Rep 2022; 9:535-562. [PMID: 35984634 PMCID: PMC9729163 DOI: 10.1007/s40572-022-00376-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Population studies show worrisome trends towards earlier breast development, difficulty in breastfeeding, and increasing rates of breast cancer in young women. Multiple epidemiological studies have linked these outcomes with chemical exposures, and experimental studies have shown that many of these chemicals generate similar effects in rodents, often by disrupting hormonal regulation. These endocrine-disrupting chemicals (EDCs) can alter the progression of mammary gland (MG) development, impair the ability to nourish offspring via lactation, increase mammary tissue density, and increase the propensity to develop cancer. However, current toxicological approaches to measuring the effects of chemical exposures on the MG are often inadequate to detect these effects, impairing our ability to identify exposures harmful to the breast and limiting opportunities for prevention. This paper describes key adverse outcomes for the MG, including impaired lactation, altered pubertal development, altered morphology (such as increased mammographic density), and cancer. It also summarizes evidence from humans and rodent models for exposures associated with these effects. We also review current toxicological practices for evaluating MG effects, highlight limitations of current methods, summarize debates related to how effects are interpreted in risk assessment, and make recommendations to strengthen assessment approaches. Increasing the rigor of MG assessment would improve our ability to identify chemicals of concern, regulate those chemicals based on their effects, and prevent exposures and associated adverse health effects.
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46
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Lester SP, Kaur AS, Vegunta S. OUP accepted manuscript. Oncologist 2022; 27:548-554. [PMID: 35536728 PMCID: PMC9256023 DOI: 10.1093/oncolo/oyac084] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
In screening for breast cancer (BC), mammographic breast density (MBD) is a powerful risk factor that increases breast carcinogenesis and synergistically reduces the sensitivity of mammography. It also reduces specificity of lesion identification, leading to recalls, additional testing, and delayed and later-stage diagnoses, which result in increased health care costs. These findings provide the foundation for dense breast notification laws and lead to the increase in patient and provider interest in MBD. However, unlike other risk factors for BC, MBD is dynamic through a woman’s lifetime and is modifiable. Although MBD is known to change as a result of factors such as reproductive history and hormonal status, few conclusions have been reached for lifestyle factors such as alcohol, diet, physical activity, smoking, body mass index (BMI), and some commonly used medications. Our review examines the emerging evidence for the association of modifiable factors on MBD and the influence of MBD on BC risk. There are clear associations between alcohol use and menopausal hormone therapy and increased MBD. Physical activity and the Mediterranean diet lower the risk of BC without significant effect on MBD. Although high BMI and smoking are known risk factors for BC, they have been found to decrease MBD. The influence of several other factors, including caffeine intake, nonhormonal medications, and vitamins, on MBD is unclear. We recommend counseling patients on these modifiable risk factors and using this knowledge to help with informed decision making for tailored BC prevention strategies.
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Affiliation(s)
- Sara P Lester
- Corresponding author: Sara P. Lester, MD, Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Aparna S Kaur
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
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Liu Y, Chen H, Heine J, Lindstrom S, Turman C, Warner ET, Winham SJ, Vachon CM, Tamimi RM, Kraft P, Jiang X. A genome-wide association study of mammographic texture variation. Breast Cancer Res 2022; 24:76. [PMCID: PMC9639267 DOI: 10.1186/s13058-022-01570-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
Background Breast parenchymal texture features, including grayscale variation (V), capture the patterns of texture variation on a mammogram and are associated with breast cancer risk, independent of mammographic density (MD). However, our knowledge on the genetic basis of these texture features is limited. Methods We conducted a genome-wide association study of V in 7040 European-ancestry women. V assessments were generated from digitized film mammograms. We used linear regression to test the single-nucleotide polymorphism (SNP)-phenotype associations adjusting for age, body mass index (BMI), MD phenotypes, and the top four genetic principal components. We further calculated genetic correlations and performed SNP-set tests of V with MD, breast cancer risk, and other breast cancer risk factors. Results We identified three genome-wide significant loci associated with V: rs138141444 (6q24.1) in ECT2L, rs79670367 (8q24.22) in LINC01591, and rs113174754 (12q22) near PGAM1P5. 6q24.1 and 8q24.22 have not previously been associated with MD phenotypes or breast cancer risk, while 12q22 is a known locus for both MD and breast cancer risk. Among known MD and breast cancer risk SNPs, we identified four variants that were associated with V at the Bonferroni-corrected thresholds accounting for the number of SNPs tested: rs335189 (5q23.2) in PRDM6, rs13256025 (8p21.2) in EBF2, rs11836164 (12p12.1) near SSPN, and rs17817449 (16q12.2) in FTO. We observed significant genetic correlations between V and mammographic dense area (rg = 0.79, P = 5.91 × 10−5), percent density (rg = 0.73, P = 1.00 × 10−4), and adult BMI (rg = − 0.36, P = 3.88 × 10−7). Additional significant relationships were observed for non-dense area (z = − 4.14, P = 3.42 × 10−5), estrogen receptor-positive breast cancer (z = 3.41, P = 6.41 × 10−4), and childhood body fatness (z = − 4.91, P = 9.05 × 10−7) from the SNP-set tests. Conclusions These findings provide new insights into the genetic basis of mammographic texture variation and their associations with MD, breast cancer risk, and other breast cancer risk factors. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-022-01570-8.
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Affiliation(s)
- Yuxi Liu
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA ,grid.38142.3c000000041936754XProgram in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 2-249A, Boston, MA 02115 USA
| | - Hongjie Chen
- grid.34477.330000000122986657Department of Epidemiology, University of Washington, Seattle, WA USA
| | - John Heine
- grid.468198.a0000 0000 9891 5233Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL USA
| | - Sara Lindstrom
- grid.34477.330000000122986657Department of Epidemiology, University of Washington, Seattle, WA USA ,grid.270240.30000 0001 2180 1622Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Constance Turman
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Erica T. Warner
- grid.38142.3c000000041936754XClinical and Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
| | - Stacey J. Winham
- grid.66875.3a0000 0004 0459 167XBiomedical Statistics and Informatics, Mayo Clinic, Rochester, MN USA
| | - Celine M. Vachon
- grid.66875.3a0000 0004 0459 167XDivision of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN USA
| | - Rulla M. Tamimi
- grid.38142.3c000000041936754XChanning Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA ,grid.5386.8000000041936877XDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY USA
| | - Peter Kraft
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA ,grid.38142.3c000000041936754XProgram in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 2-249A, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Xia Jiang
- grid.465198.7Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Visionsgatan 18, 171 77 Solna, Stockholm Sweden ,grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Bell EM, Graves ML, Dean PM, Goodman TO, Roskelley CD. Modeling Collective Invasion and Single-Cell Mesenchymal Invasion in Three-Dimensional Matrigel-Collagen I Cultures. Methods Mol Biol 2022; 2508:79-99. [PMID: 35737235 DOI: 10.1007/978-1-0716-2376-3_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Understanding the modes and mechanisms of tumor cell invasion is key to developing targeted therapies against metastatic disease. In vitro assays modeling tumor progression have primarily been optimized for studying classical single-cell migration through an epithelial-mesenchymal transition (EMT). Although experimental and clinical histopathological evidence has revealed that tumor invasion is plastic and that epithelial carcinomas can invade by a range of modes that vary from single, mesenchyme-like cells, all the way to cohesive, collective units, few in vitro assays have been designed to assess these modes specifically. Thus, we have developed a Matrigel-Collagen I overlay assay that is suitable for identifying and quantifying both collective and mesenchymal invasion. This three-dimensional (3D) culture assay utilizes the features of Matrigel and Collagen I to mimic the laminin-rich basement membrane and the stiff, fibrillar Collagen I tumor microenvironment allowing for spheroid invasion to be assessed at the interface between these two matrix components.
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Affiliation(s)
- Erin M Bell
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Marcia L Graves
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Pamela M Dean
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Tate O Goodman
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Calvin D Roskelley
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada.
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Yu T, Ye DM. The epidemiologic factors associated with breast density: A review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:53. [PMID: 36092490 PMCID: PMC9450246 DOI: 10.4103/jrms.jrms_962_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/14/2022] [Accepted: 01/26/2022] [Indexed: 11/04/2022]
Abstract
In recent years, some studies have evaluated the epidemiologic factors associated with breast density. However, the variant and inconsistent results exist. In addition, breast density has been proved to be a significant risk factor associated with breast cancer. Our review summarized the published studies and emphasized the crucial factors including epidemiological factors associated with breast density. In addition, we also discussed the potential reasons for the discrepant results with risk factors. To decrease the incidence and mortality rates for breast cancer, in clinical practice, breast density should be included for clinical risk models in addition to epidemiological factors, and physicians should get more concentrate on those women with risk factors and provide risk-based breast cancer screening regimens.
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50
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Optimal Breast Density Characterization Using a Three-Dimensional Automated Breast Densitometry System. Curr Oncol 2021; 28:5384-5394. [PMID: 34940087 PMCID: PMC8700257 DOI: 10.3390/curroncol28060448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 11/24/2022] Open
Abstract
Dense breasts are a risk factor for breast cancer. Assessment of breast density is important and radiologist-dependent. We objectively measured mammographic density using the three-dimensional automatic mammographic density measurement device Volpara™ and examined the criteria for combined use of ultrasonography (US). Of 1227 patients who underwent primary breast cancer surgery between January 2019 and April 2021 at our hospital, 441 were included. A case series study was conducted based on patient age, diagnostic accuracy, effects of mammography (MMG) combined with US, size of invasion, and calcifications. The mean density of both breasts according to the Volpara Density Grade (VDG) was 0–3.4% in 2 patients, 3.5–7.4% in 55 patients, 7.5–15.4% in 173 patients, and ≥15.5% in 211 patients. Breast density tended to be higher in younger patients. Diagnostic accuracy of MMG tended to decrease with increasing breast density. US detection rates were not associated with VDG on MMG and were favorable at all densities. The risk of a non-detected result was high in patients without malignant suspicious calcifications. Supplementary use of US for patients without suspicious calcifications on MMG and high breast density, particularly ≥25.5%, could improve the breast cancer detection rate.
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