Changes in mammographic density over time and the risk of breast cancer: An observational cohort study

Background: The effect of changes in mammographic density over time on the risk of breast cancer remains inconclusive. Methods: We used information from four centres of the Breast Cancer Screening Program in Spain in the period 1996-2015. We analysed individual level data from 117,388 women first sc...

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Detalles Bibliográficos
Autores: Roman, M, Sala, M, Bare, M, Posso, M, Vidal, C, Louro, J, Sanchez, M, Penalva, L, Castells, X, Buron, A, Domingo, L, Rodriguez-Arana, A, Servitja, S, Vernet, M, Andreu, X, Benito, L, Quintana, MJ, Sola-Roca, J, Prieto, M, Galceran, J, Saladie, F, Ferrer, J, Espinas, JA, Tora-Rocamora, I, Bargallo, X
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p2944
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/2944
Access Level:acceso abierto
Palabra clave:Breast neoplasms
Mass screening
Longitudinal studies
Mammographic density
Descripción
Sumario:Background: The effect of changes in mammographic density over time on the risk of breast cancer remains inconclusive. Methods: We used information from four centres of the Breast Cancer Screening Program in Spain in the period 1996-2015. We analysed individual level data from 117,388 women first screened age 50-54, with at least two screening examinations. Breast density was determined using the BI-RADS classification (A to D in increasing order) at earliest and latest screening examination. Adjusted Poisson regression models were used to estimate the relative risk (RR) and 95% confidence intervals (95% CI) of the association between changes in mammographic density and breast cancer risk over time. Results: During an average 5.8 years of follow-up, 1592 (1.36%) women had a breast cancer diagnosis. An increase in density category increased breast cancer risk, and a decrease in density decreased the risk, compared with women who remained in the same BI-RADS category. Women whose density category increased from B to C or B to D had a RR of 1.55 (95% CI = 1.24-1.94) and 2.32 (95% CI = 1.48-3.63), respectively. The RR for women whose density increased from C to D was 1.51 (95% CI = 1.03-2.22). Changes in BI-RADS density were similarly associated with the risk for invasive cancer than for ductal carcinoma in situ. Conclusions: Although a modest proportion of women changed BI-RADS density category, mammographic density changes modulated the risk of breast cancer and identified women at a differential risk. Using two longitudinal measures of BI-RADS density could help target women for risk-based screening strategies. (C) 2019 Elsevier Ltd. All rights reserved.

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