Breast Cancer Research (Sep 2024)
Reproductive factors and mammographic density within the International Consortium of Mammographic Density: A cross-sectional study
- Jessica O’Driscoll,
- Anya Burton,
- Gertraud Maskarinec,
- Beatriz Perez-Gomez,
- Celine Vachon,
- Hui Miao,
- Martín Lajous,
- Ruy López-Ridaura,
- A. Heather Eliassen,
- Ana Pereira,
- Maria Luisa Garmendia,
- Rulla M. Tamimi,
- Kimberly Bertrand,
- Ava Kwong,
- Giske Ursin,
- Eunjung Lee,
- Samera A. Qureshi,
- Huiyan Ma,
- Sarah Vinnicombe,
- Sue Moss,
- Steve Allen,
- Rose Ndumia,
- Sudhir Vinayak,
- Soo-Hwang Teo,
- Shivaani Mariapun,
- Farhana Fadzli,
- Beata Peplonska,
- Chisato Nagata,
- Jennifer Stone,
- John L. Hopper,
- Graham Giles,
- Vahit Ozmen,
- Mustafa Erkin Aribal,
- Joachim Schüz,
- Carla H. Van Gils,
- Johanna O. P. Wanders,
- Reza Sirous,
- Mehri Sirous,
- John Hipwell,
- Jisun Kim,
- Jong Won Lee,
- Mikael Hartman,
- Jingmei Li,
- Christopher Scott,
- Anna M. Chiarelli,
- Linda Linton,
- Marina Pollan,
- Anath Arzee Flugelman,
- Dorria Salem,
- Rasha Kamal,
- Norman Boyd,
- Isabel dos-Santos-Silva,
- Valerie McCormack,
- Maeve Mullooly
Affiliations
- Jessica O’Driscoll
- School of Population Health, RCSI University of Medicine and Health Sciences
- Anya Burton
- Bristol Medical School, Translational Health Sciences, University of Bristol, Learning and Research Building, Level 2, Southmead Hospital
- Gertraud Maskarinec
- University of Hawaii Cancer Center
- Beatriz Perez-Gomez
- Instituto de Salud Carlos III
- Celine Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic
- Hui Miao
- Saw Swee Hock School of Public Health, National University of Singapore
- Martín Lajous
- Instituto Nacional de Salud Pública
- Ruy López-Ridaura
- Instituto Nacional de Salud Pública
- A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
- Ana Pereira
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile
- Maria Luisa Garmendia
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile
- Rulla M. Tamimi
- Population Health Sciences, Weill Cornell Medicine
- Kimberly Bertrand
- Slone Epidemiology Center, Boston University
- Ava Kwong
- Division of Breast Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong
- Giske Ursin
- Cancer Registry of Norway, Norwegian Institute of Public Health
- Eunjung Lee
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
- Samera A. Qureshi
- Unit for Migration & Health, Norwegian Institute of Public Health
- Huiyan Ma
- Department of Computational and Quantitative Medicine, City of Hope National Medical Center
- Sarah Vinnicombe
- Division of Cancer Research, Ninewells Hospital and Medical School
- Sue Moss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London
- Steve Allen
- Department of Diagnostic Radiology, Royal Marsden NHS Foundation Trust
- Rose Ndumia
- Aga Khan University Hospital
- Sudhir Vinayak
- Aga Khan University Hospital
- Soo-Hwang Teo
- Breast Cancer Research Group, University of Malaya Medical Centre, University of Malaya
- Shivaani Mariapun
- Cancer Research Malaysia
- Farhana Fadzli
- Breast Cancer Research Unit, Faculty of Medicine, University of Malaya Cancer Research Institute, University of Malaya
- Beata Peplonska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine
- Chisato Nagata
- Department of Epidemiology & Preventive Medicine, Graduate School of Medicine, Gifu University
- Jennifer Stone
- Genetic Epidemiology Group, School of Population and Global Health, University of Western Australia
- John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne
- Graham Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne
- Vahit Ozmen
- Faculty of Medicine, Istanbul University
- Mustafa Erkin Aribal
- Department of Radiology, School of Medicine, Acibadem University
- Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer
- Carla H. Van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht
- Johanna O. P. Wanders
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht
- Reza Sirous
- Department of Radiology and Biomedical Imaging, University of California San Francisco
- Mehri Sirous
- Radiology Department, Isfahan University of Medical Sciences
- John Hipwell
- Centre for Medical Image Computing, University College London
- Jisun Kim
- Asan Medical Center
- Jong Won Lee
- Asan Medical Center
- Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore
- Jingmei Li
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore
- Christopher Scott
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic
- Anna M. Chiarelli
- Ontario Breast Screening Program, Cancer Care Ontario
- Linda Linton
- Princess Margaret Cancer Centre
- Marina Pollan
- Instituto de Salud Carlos III
- Anath Arzee Flugelman
- The Rapport Faculty of Medicine, Technion-Israel Institute of Technology
- Dorria Salem
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals
- Rasha Kamal
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals
- Norman Boyd
- Princess Margaret Cancer Centre
- Isabel dos-Santos-Silva
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals
- Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer
- Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences
- DOI
- https://doi.org/10.1186/s13058-024-01890-x
- Journal volume & issue
-
Vol. 26,
no. 1
pp. 1 – 17
Abstract
Abstract Background Elevated mammographic density (MD) for a woman’s age and body mass index (BMI) is an established breast cancer risk factor. The relationship of parity, age at first birth, and breastfeeding with MD is less clear. We examined the associations of these factors with MD within the International Consortium of Mammographic Density (ICMD). Methods ICMD is a consortium of 27 studies with pooled individual-level epidemiological and MD data from 11,755 women without breast cancer aged 35–85 years from 22 countries, capturing 40 country-& ethnicity-specific population groups. MD was measured using the area-based tool Cumulus. Meta-analyses across population groups and pooled analyses were used to examine linear regression associations of square-root (√) transformed MD measures (percent MD (PMD), dense area (DA), and non-dense area (NDA)) with parity, age at first birth, ever/never breastfed and lifetime breastfeeding duration. Models were adjusted for age at mammogram, age at menarche, BMI, menopausal status, use of hormone replacement therapy, calibration method, mammogram view and reader, and parity and age at first birth when not the association of interest. Results Among 10,988 women included in these analyses, 90.1% (n = 9,895) were parous, of whom 13% (n = 1,286) had ≥ five births. The mean age at first birth was 24.3 years (Standard deviation = 5.1). Increasing parity (per birth) was inversely associated with √PMD (β: − 0.05, 95% confidence interval (CI): − 0.07, − 0.03) and √DA (β: − 0.08, 95% CI: − 0.12, − 0.05) with this trend evident until at least nine births. Women who were older at first birth (per five-year increase) had higher √PMD (β:0.06, 95% CI:0.03, 0.10) and √DA (β:0.06, 95% CI:0.02, 0.10), and lower √NDA (β: − 0.06, 95% CI: − 0.11, − 0.01). In stratified analyses, this association was only evident in women who were post-menopausal at MD assessment. Among parous women, no associations were found between ever/never breastfed or lifetime breastfeeding duration (per six-month increase) and √MD. Conclusions Associations with higher parity and older age at first birth with √MD were consistent with the direction of their respective associations with breast cancer risk. Further research is needed to understand reproductive factor-related differences in the composition of breast tissue and their associations with breast cancer risk.
Keywords