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Breast Density Change Over Time and Risk for Breast Cancer
Breast density is an established risk factor for the development of breast cancer, but changes in breast density over time and their correlation with risk is less clear due to limited investigation. Now, in a nested, case-control, cohort study, investigators examined changes in breast density using a sample from the Joanne Knight Breast Health Cohort of 10,481 women who were cancer-free at entry and were observed from 2008 to 2020 with screening mammograms every 1 to 2 years.
The study sample included 289 pathology-confirmed breast cancer cases and 658 controls matched for age and year of enrollment, with a total of 8710 mammograms. Most women were white (81%), 15% were Black. Most women in both the case and control groups were postmenopausal and parous. When the mean volumetric density of the two breasts was analyzed, breast density at study entry was significantly higher in cases than controls but the rate of change (decrease) in breast density over time did not differ between cases and controls. However, when density change in each breast was analyzed separately, the rate of density change over time in breasts that developed cancer was significantly slower than the rate of change in breasts of controls.
The rate of decrease in density of the breast was significantly slower in women who developed breast cancer than in those who did not. These findings suggest that the dynamic change in breast density over time could serve as a tool to provide better insight into individual risk. For women whose breast density is not changing in any meaningful way, more emphasis may be placed on risk-reduction strategies, either standard or investigational. This study was conducted in a mostly white population and study of a more diverse population would validate whether these findings are widely applicable.
Jiang S et al.
Title: Longitudinal analysis of change in mammographic density in each breast and its association with breast cancer risk.
Source: JAMA Oncol 2023 Apr 27; [e-pub]. (Abstract/FREE Full Text)