Abstract
Breast density is a risk factor for breast cancer. This study explored distribution of mammographic density quantitatively and qualitatively in a wide age range of Taiwanese women. Subjects with negative and benign mammographic findings were included. According to the Breast Imaging Reporting and Data System, the proportion of extremely dense breasts declined from 58.0% in women < 30 years to 1.9% in women > 74 years. More than 80% of mammograms in women < 55 years old were classified as extremely or heterogeneously dense, while the proportion of dense breasts was still high in women aged 60–64 years (59.3%). The absolute dense area of the breast declined from 35.8% in women < 30 years to 18.5% in women > 74 years. The correlation between breast density and age was significant, with and without controlling for the effect of body composition (p < 0.001), implying that the relationship between breast density and age was not wholly related to body composition. In conclusion, the higher breast density in Taiwanese women aged 60–64 years was comparable to that of Western women aged 40–44 years in the literature. This suggests that breast cancer screening using mammography may be more challenging for Asian women than for Western women of the same age.
Highlights
Screening mammography is a periodic mammogram used to early detect and diagnose breast cancer in women without breast symptoms [1,2]
The concordance between two Breast Imaging-Reporting and Data System (BI-RADS) breast density reports assessed on two occasions 3 months apart by the same radiologist was very good
The benefits of screening mammography in women < 40 years have not been established and exposure to ionizing radiation involves some risk [30]. Another disadvantage of early mammography is that young women tend to have dense breasts and less effective mammography
Summary
Screening mammography is a periodic mammogram used to early detect and diagnose breast cancer in women without breast symptoms [1,2]. The main epidemiological differences between women in Asian and Western countries are the overall lower incidence rates and younger age of peak incidence in Asian women [4,5]. In Western countries, breast cancer incidence peaks at 60–80 years [6,7], whereas in Asian countries, it plateaus or decreases after 45–50 years [4,8,9,10,11]. In Asia, the peak incidence of breast cancer occurs in younger women compared to women in Western countries. Age stratification study showed similar incidence rates of breast cancer in younger Asian and Western populations [10]. The differences in the incidence of breast cancer between generations in Asian women may due to the westernization
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