Mammographic density by time and breast: a retrospective cohort study from BreastScreen Norway

Abstract Background Mammographic density is known to decrease over time in postmenopausal women. Longitudinal changes in mammographic density prior to breast cancer diagnosis have been widely discussed and less density reduction has been observed for breast developing versus not developing cancer. W...

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Main Authors: Nataliia Moshina, Jonas Gjesvik, Tone Hovda, Henrik W. Koch, Heinrich A. Backmann, Solveig Hofvind
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Breast Cancer Research
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Online Access:https://doi.org/10.1186/s13058-025-02037-2
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author Nataliia Moshina
Jonas Gjesvik
Tone Hovda
Henrik W. Koch
Heinrich A. Backmann
Solveig Hofvind
author_facet Nataliia Moshina
Jonas Gjesvik
Tone Hovda
Henrik W. Koch
Heinrich A. Backmann
Solveig Hofvind
author_sort Nataliia Moshina
collection DOAJ
description Abstract Background Mammographic density is known to decrease over time in postmenopausal women. Longitudinal changes in mammographic density prior to breast cancer diagnosis have been widely discussed and less density reduction has been observed for breast developing versus not developing cancer. We aimed to verify these findings among participants of BreastScreen Norway. Methods In this retrospective cohort study, data from 78,182 women aged 50–69 years who attended three consecutive screening rounds between 2007 and 2020 were included. Among those women, 970 were diagnosed with screen-detected and 308 with interval cancer. Mammographic density data was obtained from an automated software and included absolute (cm3) and percent (%) dense volume for each breast and for each woman, per examination. A linear mixed-effects regression model estimating differences in density between the breast developing and not developing cancer was applied to evaluate longitudinal changes, separately for absolute and percent dense volume. The model was adjusted for age at first screening examination, breast volume, follow-up time, history of benign breast disease, body mass index, family history, hormone therapy, use of alcohol and smoking. Results were presented as linear regression coefficient estimates with 95% confidence intervals (CI). Results Mean age at the third screening examination for women without breast cancer was 62.5 (standard deviation, SD: 5.1) years, while mean age at diagnosis was 62.3 (SD: 4.4) years for women with screen-detected cancer and 61.9 (SD: 4.8) years for women with interval cancer. In our model, absolute and percent dense volume decreased with follow-up time, estimate=-0.010 (95%CI -0.010; -0.009) and estimate=-0.013 (95%CI -0.014; -0.013), respectively, indicating the overall negative effect of time on mammographic density. The interaction between time and development of breast cancer was positive for absolute and percent dense volume, estimate = 0.009 (95%CI 0.004; 0.014) for both, which implied that mammographic density in breasts developing cancer was stable or slightly decreasing. Conclusions Less reduction in longitudinally assessed mammographic density was observed for breasts developing versus not developing cancer in our study. This difference might be used for more precise 4–6 years breast cancer risk prediction and screening personalization.
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spelling doaj-art-6ecda4fbf27341f1a4a2b92639bb7ffd2025-08-20T02:25:17ZengBMCBreast Cancer Research1465-542X2025-05-0127111110.1186/s13058-025-02037-2Mammographic density by time and breast: a retrospective cohort study from BreastScreen NorwayNataliia Moshina0Jonas Gjesvik1Tone Hovda2Henrik W. Koch3Heinrich A. Backmann4Solveig Hofvind5The Cancer Registry of Norway, Department of Screening programs, Norwegian Institute of Public HealthThe Cancer Registry of Norway, Department of Screening programs, Norwegian Institute of Public HealthDepartment of Radiology, Vestre Viken Hospital TrustDepartment of Radiology, Stavanger University HospitalDepartment of Radiology, Nordland Hospital TrustThe Cancer Registry of Norway, Department of Screening programs, Norwegian Institute of Public HealthAbstract Background Mammographic density is known to decrease over time in postmenopausal women. Longitudinal changes in mammographic density prior to breast cancer diagnosis have been widely discussed and less density reduction has been observed for breast developing versus not developing cancer. We aimed to verify these findings among participants of BreastScreen Norway. Methods In this retrospective cohort study, data from 78,182 women aged 50–69 years who attended three consecutive screening rounds between 2007 and 2020 were included. Among those women, 970 were diagnosed with screen-detected and 308 with interval cancer. Mammographic density data was obtained from an automated software and included absolute (cm3) and percent (%) dense volume for each breast and for each woman, per examination. A linear mixed-effects regression model estimating differences in density between the breast developing and not developing cancer was applied to evaluate longitudinal changes, separately for absolute and percent dense volume. The model was adjusted for age at first screening examination, breast volume, follow-up time, history of benign breast disease, body mass index, family history, hormone therapy, use of alcohol and smoking. Results were presented as linear regression coefficient estimates with 95% confidence intervals (CI). Results Mean age at the third screening examination for women without breast cancer was 62.5 (standard deviation, SD: 5.1) years, while mean age at diagnosis was 62.3 (SD: 4.4) years for women with screen-detected cancer and 61.9 (SD: 4.8) years for women with interval cancer. In our model, absolute and percent dense volume decreased with follow-up time, estimate=-0.010 (95%CI -0.010; -0.009) and estimate=-0.013 (95%CI -0.014; -0.013), respectively, indicating the overall negative effect of time on mammographic density. The interaction between time and development of breast cancer was positive for absolute and percent dense volume, estimate = 0.009 (95%CI 0.004; 0.014) for both, which implied that mammographic density in breasts developing cancer was stable or slightly decreasing. Conclusions Less reduction in longitudinally assessed mammographic density was observed for breasts developing versus not developing cancer in our study. This difference might be used for more precise 4–6 years breast cancer risk prediction and screening personalization.https://doi.org/10.1186/s13058-025-02037-2Breast cancerRiskBreast densityMammographyScreening
spellingShingle Nataliia Moshina
Jonas Gjesvik
Tone Hovda
Henrik W. Koch
Heinrich A. Backmann
Solveig Hofvind
Mammographic density by time and breast: a retrospective cohort study from BreastScreen Norway
Breast Cancer Research
Breast cancer
Risk
Breast density
Mammography
Screening
title Mammographic density by time and breast: a retrospective cohort study from BreastScreen Norway
title_full Mammographic density by time and breast: a retrospective cohort study from BreastScreen Norway
title_fullStr Mammographic density by time and breast: a retrospective cohort study from BreastScreen Norway
title_full_unstemmed Mammographic density by time and breast: a retrospective cohort study from BreastScreen Norway
title_short Mammographic density by time and breast: a retrospective cohort study from BreastScreen Norway
title_sort mammographic density by time and breast a retrospective cohort study from breastscreen norway
topic Breast cancer
Risk
Breast density
Mammography
Screening
url https://doi.org/10.1186/s13058-025-02037-2
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