Changes in mammographic density over time and the risk of breast cancer: An observational cohort study
Por:
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
Publicada:
1 ago 2019
Resumen:
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.
Filiaciones:
Roman, M:
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
IMIM Hosp del Mar Med Res Inst, Dept Epidemiol & Evaluat, Passeig Maritim 25-29, Barcelona 08003, Spain
Res Network Hlth Serv Chron Dis REDISSEC, Barcelona, Spain
Sala, M:
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Res Network Hlth Serv Chron Dis REDISSEC, Barcelona, Spain
IMIM Hosp del Mar Med Res Inst, Dept Epidemiol & Evaluat, Passeig Maritim 25-29, Barcelona 08003, Spain
Bare, M:
Parc Tauli Univ Hosp, Sabadell, Spain
Res Network Hlth Serv Chron Dis REDISSEC, Barcelona, Spain
Parc Tauli Univ Hosp, Clin Epidemiol & Canc Screening, Sabadell, Spain
Posso, M:
IMIM Hosp del Mar Med Res Inst, Dept Epidemiol & Evaluat, Passeig Maritim 25-29, Barcelona 08003, Spain
Res Network Hlth Serv Chron Dis REDISSEC, Barcelona, Spain
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Vidal, C:
Catalan Inst Oncol, Canc Prevent & Monitoring Program, Barcelona, Spain
Louro, J:
Res Network Hlth Serv Chron Dis REDISSEC, Barcelona, Spain
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
IMIM Hosp del Mar Med Res Inst, Dept Epidemiol & Evaluat, Passeig Maritim 25-29, Barcelona 08003, Spain
Sanchez, M:
Govt Cantabria, Gen Directorate Publ Hlth, Santander, Spain
Penalva, L:
Private Fdn Asil Hosp, Granollers, Spain
Private Fdn Asil Hosp, Breast Canc Screening Tech Off, Granollers, Spain
Castells, X:
Res Network Hlth Serv Chron Dis REDISSEC, Barcelona, Spain
IMIM Hosp del Mar Med Res Inst, Dept Epidemiol & Evaluat, Passeig Maritim 25-29, Barcelona 08003, Spain
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Buron, A:
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Domingo, L:
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Rodriguez-Arana, A:
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Servitja, S:
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Vernet, M:
IMIM Hosp del Mar Med Res Inst, Barcelona, Spain
Andreu, X:
Parc Tauli Univ Hosp, Sabadell, Spain
Benito, L:
Catalan Inst Oncol, Canc Prevent & Monitoring Program, Barcelona, Spain
Quintana, MJ:
Hosp Santa Creu & Sant Pau, Epidemiol Dept, Barcelona, Spain
Sola-Roca, J:
Hosp Santa Creu & Sant Pau, Epidemiol Dept, Barcelona, Spain
Prieto, M:
Principal Asturias Hlth Serv, Asturias, Spain
Galceran, J:
Univ Rovira & Virgili, Fdn Lliga Invest & Prevencio Canc, Tarragona, Spain
Saladie, F:
Univ Rovira & Virgili, Fdn Lliga Invest & Prevencio Canc, Tarragona, Spain
Ferrer, J:
Hosp Santa Caterina, Girona, Spain
Espinas, JA:
Dept Hlth, Catalan Canc Plan, Barcelona, Spain
Tora-Rocamora, I:
Hosp Clin Barcelona, Prevent Med & Epidemiol Dept, Barcelona, Spain
Bargallo, X:
Hosp Clin Barcelona, Prevent Med & Epidemiol Dept, Barcelona, Spain
Green Accepted
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