Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide.
<h4>Background</h4>Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known.<h4>Methods and findings</h4>...
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Public Library of Science (PLoS)
2017-06-01
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| Series: | PLoS Medicine |
| Online Access: | https://doi.org/10.1371/journal.pmed.1002335 |
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| author | Anya Burton Gertraud Maskarinec Beatriz Perez-Gomez Celine Vachon Hui Miao Martín Lajous Ruy López-Ridaura Megan Rice 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 Agnieszka Bukowska Chisato Nagata Jennifer Stone John 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 Caroline Dickens Mikael Hartman Kee-Seng Chia Christopher Scott Anna M Chiarelli Linda Linton Marina Pollan Anath Arzee Flugelman Dorria Salem Rasha Kamal Norman Boyd Isabel Dos-Santos-Silva Valerie McCormack |
| author_facet | Anya Burton Gertraud Maskarinec Beatriz Perez-Gomez Celine Vachon Hui Miao Martín Lajous Ruy López-Ridaura Megan Rice 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 Agnieszka Bukowska Chisato Nagata Jennifer Stone John 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 Caroline Dickens Mikael Hartman Kee-Seng Chia Christopher Scott Anna M Chiarelli Linda Linton Marina Pollan Anath Arzee Flugelman Dorria Salem Rasha Kamal Norman Boyd Isabel Dos-Santos-Silva Valerie McCormack |
| author_sort | Anya Burton |
| collection | DOAJ |
| description | <h4>Background</h4>Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known.<h4>Methods and findings</h4>We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35-85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD) between post- and premenopausal women was apparent (-0.46 cm [95% CI: -0.53, -0.39]) and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2) was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was -0.24 cm (95% CI: -0.34, -0.14; I2 = 30%), reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area). In postmenopausal women, the corresponding difference in √PD (-0.38 cm [95% CI: -0.44, -0.33]; I2 = 30%) was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature.<h4>Conclusions</h4>Declines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to women. If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction. |
| format | Article |
| id | doaj-art-09ec9150a21844fe90bce8f94d3958ca |
| institution | OA Journals |
| issn | 1549-1277 1549-1676 |
| language | English |
| publishDate | 2017-06-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj-art-09ec9150a21844fe90bce8f94d3958ca2025-08-20T02:22:06ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762017-06-01146e100233510.1371/journal.pmed.1002335Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide.Anya BurtonGertraud MaskarinecBeatriz Perez-GomezCeline VachonHui MiaoMartín LajousRuy López-RidauraMegan RiceAna PereiraMaria Luisa GarmendiaRulla M TamimiKimberly BertrandAva KwongGiske UrsinEunjung LeeSamera A QureshiHuiyan MaSarah VinnicombeSue MossSteve AllenRose NdumiaSudhir VinayakSoo-Hwang TeoShivaani MariapunFarhana FadzliBeata PeplonskaAgnieszka BukowskaChisato NagataJennifer StoneJohn HopperGraham GilesVahit OzmenMustafa Erkin AribalJoachim SchüzCarla H Van GilsJohanna O P WandersReza SirousMehri SirousJohn HipwellJisun KimJong Won LeeCaroline DickensMikael HartmanKee-Seng ChiaChristopher ScottAnna M ChiarelliLinda LintonMarina PollanAnath Arzee FlugelmanDorria SalemRasha KamalNorman BoydIsabel Dos-Santos-SilvaValerie McCormack<h4>Background</h4>Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known.<h4>Methods and findings</h4>We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35-85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD) between post- and premenopausal women was apparent (-0.46 cm [95% CI: -0.53, -0.39]) and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2) was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was -0.24 cm (95% CI: -0.34, -0.14; I2 = 30%), reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area). In postmenopausal women, the corresponding difference in √PD (-0.38 cm [95% CI: -0.44, -0.33]; I2 = 30%) was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature.<h4>Conclusions</h4>Declines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to women. If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction.https://doi.org/10.1371/journal.pmed.1002335 |
| spellingShingle | Anya Burton Gertraud Maskarinec Beatriz Perez-Gomez Celine Vachon Hui Miao Martín Lajous Ruy López-Ridaura Megan Rice 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 Agnieszka Bukowska Chisato Nagata Jennifer Stone John 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 Caroline Dickens Mikael Hartman Kee-Seng Chia Christopher Scott Anna M Chiarelli Linda Linton Marina Pollan Anath Arzee Flugelman Dorria Salem Rasha Kamal Norman Boyd Isabel Dos-Santos-Silva Valerie McCormack Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. PLoS Medicine |
| title | Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. |
| title_full | Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. |
| title_fullStr | Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. |
| title_full_unstemmed | Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. |
| title_short | Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. |
| title_sort | mammographic density and ageing a collaborative pooled analysis of cross sectional data from 22 countries worldwide |
| url | https://doi.org/10.1371/journal.pmed.1002335 |
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