Combined effect of volumetric breast density and body mass index on breast cancer risk

Natalie J. Engmann, Christopher G. Scott, Matthew R. Jensen, Stacey Winham, Diana L Miglioretti, Lin Ma, Kathleen Brandt, Amir Mahmoudzadeh, Dana H. Whaley, Carrie Hruska, Fang Wu, Aaron D. Norman, Robert A. Hiatt, John Heine, John Shepherd, V. Shane Pankratz, Celine M. Vachon, Karla Kerlikowske

Research output: Contribution to journalArticle

Abstract

Background: Breast density and body mass index (BMI) are used for breast cancer risk stratification. We evaluate whether the positive association between volumetric breast density and breast cancer risk is strengthened with increasing BMI. Methods: The San Francisco Mammography Registry and Mayo Clinic Rochester identified 781 premenopausal and 1850 postmenopausal women with breast cancer diagnosed between 2007 and 2015 that had a screening digital mammogram at least 6 months prior to diagnosis. Up to three controls (N = 3535) were matched per case on age, race, date, mammography machine, and state. Volumetric percent density (VPD) and dense volume (DV) were measured with Volpara™. Breast cancer risk was assessed with logistic regression stratified by menopause status. Multiplicative interaction tests assessed whether the association of density measures was differential by BMI categories. Results: The increased risk of breast cancer associated with VPD was strengthened with higher BMI for both premenopausal (pinteraction = 0.01) and postmenopausal (pinteraction = 0.0003) women. For BMI < 25, 25–30, and ≥ 30 kg/m2, ORs for breast cancer for a 1 SD increase in VPD were 1.24, 1.65, and 1.97 for premenopausal, and 1.20, 1.55, and 2.25 for postmenopausal women, respectively. ORs for breast cancer for a 1 SD increase in DV were 1.39, 1.33, and 1.51 for premenopausal (pinteraction = 0.58), and 1.31, 1.34, and 1.65 (pinteraction = 0.03) for postmenopausal women for BMI < 25, 25–30 and ≥ 30 kg/m2, respectively. Conclusions: The effect of volumetric percent density on breast cancer risk is strongest in overweight and obese women. These associations have clinical relevance for informing prevention strategies.

Original languageEnglish (US)
JournalBreast Cancer Research and Treatment
DOIs
StatePublished - Jan 1 2019

Fingerprint

Body Mass Index
Breast Neoplasms
Mammography
San Francisco
Breast Density
Menopause
Registries
Logistic Models

Keywords

  • Body mass index
  • Breast cancer
  • Breast density
  • Mammographic density

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Combined effect of volumetric breast density and body mass index on breast cancer risk. / Engmann, Natalie J.; Scott, Christopher G.; Jensen, Matthew R.; Winham, Stacey; Miglioretti, Diana L; Ma, Lin; Brandt, Kathleen; Mahmoudzadeh, Amir; Whaley, Dana H.; Hruska, Carrie; Wu, Fang; Norman, Aaron D.; Hiatt, Robert A.; Heine, John; Shepherd, John; Pankratz, V. Shane; Vachon, Celine M.; Kerlikowske, Karla.

In: Breast Cancer Research and Treatment, 01.01.2019.

Research output: Contribution to journalArticle

Engmann, NJ, Scott, CG, Jensen, MR, Winham, S, Miglioretti, DL, Ma, L, Brandt, K, Mahmoudzadeh, A, Whaley, DH, Hruska, C, Wu, F, Norman, AD, Hiatt, RA, Heine, J, Shepherd, J, Pankratz, VS, Vachon, CM & Kerlikowske, K 2019, 'Combined effect of volumetric breast density and body mass index on breast cancer risk', Breast Cancer Research and Treatment. https://doi.org/10.1007/s10549-019-05283-z
Engmann, Natalie J. ; Scott, Christopher G. ; Jensen, Matthew R. ; Winham, Stacey ; Miglioretti, Diana L ; Ma, Lin ; Brandt, Kathleen ; Mahmoudzadeh, Amir ; Whaley, Dana H. ; Hruska, Carrie ; Wu, Fang ; Norman, Aaron D. ; Hiatt, Robert A. ; Heine, John ; Shepherd, John ; Pankratz, V. Shane ; Vachon, Celine M. ; Kerlikowske, Karla. / Combined effect of volumetric breast density and body mass index on breast cancer risk. In: Breast Cancer Research and Treatment. 2019.
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abstract = "Background: Breast density and body mass index (BMI) are used for breast cancer risk stratification. We evaluate whether the positive association between volumetric breast density and breast cancer risk is strengthened with increasing BMI. Methods: The San Francisco Mammography Registry and Mayo Clinic Rochester identified 781 premenopausal and 1850 postmenopausal women with breast cancer diagnosed between 2007 and 2015 that had a screening digital mammogram at least 6 months prior to diagnosis. Up to three controls (N = 3535) were matched per case on age, race, date, mammography machine, and state. Volumetric percent density (VPD) and dense volume (DV) were measured with Volpara™. Breast cancer risk was assessed with logistic regression stratified by menopause status. Multiplicative interaction tests assessed whether the association of density measures was differential by BMI categories. Results: The increased risk of breast cancer associated with VPD was strengthened with higher BMI for both premenopausal (pinteraction = 0.01) and postmenopausal (pinteraction = 0.0003) women. For BMI < 25, 25–30, and ≥ 30 kg/m2, ORs for breast cancer for a 1 SD increase in VPD were 1.24, 1.65, and 1.97 for premenopausal, and 1.20, 1.55, and 2.25 for postmenopausal women, respectively. ORs for breast cancer for a 1 SD increase in DV were 1.39, 1.33, and 1.51 for premenopausal (pinteraction = 0.58), and 1.31, 1.34, and 1.65 (pinteraction = 0.03) for postmenopausal women for BMI < 25, 25–30 and ≥ 30 kg/m2, respectively. Conclusions: The effect of volumetric percent density on breast cancer risk is strongest in overweight and obese women. These associations have clinical relevance for informing prevention strategies.",
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T1 - Combined effect of volumetric breast density and body mass index on breast cancer risk

AU - Engmann, Natalie J.

AU - Scott, Christopher G.

AU - Jensen, Matthew R.

AU - Winham, Stacey

AU - Miglioretti, Diana L

AU - Ma, Lin

AU - Brandt, Kathleen

AU - Mahmoudzadeh, Amir

AU - Whaley, Dana H.

AU - Hruska, Carrie

AU - Wu, Fang

AU - Norman, Aaron D.

AU - Hiatt, Robert A.

AU - Heine, John

AU - Shepherd, John

AU - Pankratz, V. Shane

AU - Vachon, Celine M.

AU - Kerlikowske, Karla

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N2 - Background: Breast density and body mass index (BMI) are used for breast cancer risk stratification. We evaluate whether the positive association between volumetric breast density and breast cancer risk is strengthened with increasing BMI. Methods: The San Francisco Mammography Registry and Mayo Clinic Rochester identified 781 premenopausal and 1850 postmenopausal women with breast cancer diagnosed between 2007 and 2015 that had a screening digital mammogram at least 6 months prior to diagnosis. Up to three controls (N = 3535) were matched per case on age, race, date, mammography machine, and state. Volumetric percent density (VPD) and dense volume (DV) were measured with Volpara™. Breast cancer risk was assessed with logistic regression stratified by menopause status. Multiplicative interaction tests assessed whether the association of density measures was differential by BMI categories. Results: The increased risk of breast cancer associated with VPD was strengthened with higher BMI for both premenopausal (pinteraction = 0.01) and postmenopausal (pinteraction = 0.0003) women. For BMI < 25, 25–30, and ≥ 30 kg/m2, ORs for breast cancer for a 1 SD increase in VPD were 1.24, 1.65, and 1.97 for premenopausal, and 1.20, 1.55, and 2.25 for postmenopausal women, respectively. ORs for breast cancer for a 1 SD increase in DV were 1.39, 1.33, and 1.51 for premenopausal (pinteraction = 0.58), and 1.31, 1.34, and 1.65 (pinteraction = 0.03) for postmenopausal women for BMI < 25, 25–30 and ≥ 30 kg/m2, respectively. Conclusions: The effect of volumetric percent density on breast cancer risk is strongest in overweight and obese women. These associations have clinical relevance for informing prevention strategies.

AB - Background: Breast density and body mass index (BMI) are used for breast cancer risk stratification. We evaluate whether the positive association between volumetric breast density and breast cancer risk is strengthened with increasing BMI. Methods: The San Francisco Mammography Registry and Mayo Clinic Rochester identified 781 premenopausal and 1850 postmenopausal women with breast cancer diagnosed between 2007 and 2015 that had a screening digital mammogram at least 6 months prior to diagnosis. Up to three controls (N = 3535) were matched per case on age, race, date, mammography machine, and state. Volumetric percent density (VPD) and dense volume (DV) were measured with Volpara™. Breast cancer risk was assessed with logistic regression stratified by menopause status. Multiplicative interaction tests assessed whether the association of density measures was differential by BMI categories. Results: The increased risk of breast cancer associated with VPD was strengthened with higher BMI for both premenopausal (pinteraction = 0.01) and postmenopausal (pinteraction = 0.0003) women. For BMI < 25, 25–30, and ≥ 30 kg/m2, ORs for breast cancer for a 1 SD increase in VPD were 1.24, 1.65, and 1.97 for premenopausal, and 1.20, 1.55, and 2.25 for postmenopausal women, respectively. ORs for breast cancer for a 1 SD increase in DV were 1.39, 1.33, and 1.51 for premenopausal (pinteraction = 0.58), and 1.31, 1.34, and 1.65 (pinteraction = 0.03) for postmenopausal women for BMI < 25, 25–30 and ≥ 30 kg/m2, respectively. Conclusions: The effect of volumetric percent density on breast cancer risk is strongest in overweight and obese women. These associations have clinical relevance for informing prevention strategies.

KW - Body mass index

KW - Breast cancer

KW - Breast density

KW - Mammographic density

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