Abstract
Breast cancer is one of the common cancers among Malaysians and there are associated risk factors which include breast density. Therefore, this study was done to determine the association of breast cancer risks among ethnic groups in relation to breast density. Mammography was done on 300 women with equal numbers of Malays, Chinese and Indians with a mean age of 53.35 ± 7.4 years. Mammograms were evaluated using BI-RADS (Breast Imaging Reporting and Data System) protocol by two independent radiologists for breast density categorization. Chi-square analysis showed an association between breast density and age factor (p 0.05) whereas body mass index (BMI) was inversely associated with breast density (p > 0.05). There was significant difference in number of children and menopausal status (p 0.05). Results showed that 65% of Chinese subjects had denser breast density composition as to 50% in Malays and 35% in Indians. There was significant difference between breast density of three ethnic groups (p 0.05) with Chinese having 2.4 times denser breast (OR = 2.45, 95% CI: 1.466 - 3.948) followed by Malays (OR = 1.020, 95% CI: 0.681 - 1.689) and lowest in Indians (OR = 0.406, 95% CI: 0.247 - 0.668). Based on breast density, the Chinese are at a higher risk of developing breast cancer followed by Malays and lastly Indians.
Highlights
3525 women had been diagnosed with breast cancer in 2006 and represents 31% of the total number of cancer diagnosed in women [1]
Interpretation of mammograms were done by two independent radiologists with a minimum of five years experience based on Breast Imaging Reporting and Data System (BI-RADS) protocol which used four categories of breast tissues; almost entirely fat (I), scattered fibroglandular tissue (II), heterogeneously dense (III), and extremely dense (IV)
There was no significant difference for age at menarche (p = 0.905), age at first pregnancy (p = 0.414), family history of breast cancer, menopausal and marital status (p > 0.05)
Summary
3525 women had been diagnosed with breast cancer in 2006 and represents 31% of the total number of cancer diagnosed in women [1]. Mammography is an x-ray examination that utilizes low dose of radiation for imaging the breast in two projections and has the ability to detect 80 - 90 percent of breast cancer in women prior to having any symptoms. Variations in the characteristics of these tissues enable it to be categorized qualitatively and quantitatively to various breast density [2]. It is a problem in identifying cancer tissue in dense breast compared to less dense breast due to similar radiographic characteristic seen on mammograms [3]. It is important that categorization of breast density evaluated on mammogram is able to predict risk of cancer [4,5]
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