Abstract
BackgroundMammographic breast density is a useful marker for breast cancer risk, as breast density is considered one of the strongest breast cancer risk factors. The study objective was to evaluate and compare mammographic breast density in infertile and parous women, as infertility may be associated with high breast density and cancer occurrence.MethodsThis study evaluated mammographic breast density using two different systems, BIRADS and Boyd. A selected patient population of 151 women with primary infertility (case group) was compared to 154 parous women who had at least one previous pregnancy (control group). Both groups were premenopausal women aged ≥35.ResultsEvaluation of mammographic features showed that 66.9 % of case group patients and 53.9 % of control group patients were classified BIRADS-3/BIRADS-4; p < 0.05. Adjusted Odds ratio for the case group in the categories BIRADS-3/BIRADS-4 was 1.78 (95 % CI: 1.10-2.89). Using the Boyd classification system, 53.6 % of case group patients and 31.8 % of control group patients were classified E/F; p < 0.05. Adjusted Odds ratio for case group patients in Boyd categories E/F was 2.05 (95 % CI: 1.07-3.93).ConclusionsBoth systems yielded a higher percentage of increased breast density in the case group. Boyd and BIRADS classification systems indicate to what extend breast cancer lesions may be missed on mammography due to masking by dense tissue. Therefore, patients with a high BIRADS or Boyd score should undergo further investigation.
Highlights
Mammographic breast density is a useful marker for breast cancer risk, as breast density is considered one of the strongest breast cancer risk factors
We found that 68 % of women with primary infertility had dense breast tissue according to the Breast imaging-reporting and data system (BIRADS) score compared with 37 % of premenopausal women in a general population [17]
The study included women with primary infertility referred to our Breast Unit at the Department of Gynaecology and Obstetrics, University of Rome “Sapienza” as well as a control group selected from the database of the Department of Radiology
Summary
Mammographic breast density is a useful marker for breast cancer risk, as breast density is considered one of the strongest breast cancer risk factors. The study objective was to evaluate and compare mammographic breast density in infertile and parous women, as infertility may be associated with high breast density and cancer occurrence. Few studies are reported on breast cancer risk in infertile women who have undergone IVF treatment [6,7,8]. Weiss et al [10] found that among women with a first full-term delivery at the age of 35 or older, fertility problems were associated with a two-fold increased risk of breast cancer. Venn et al [5] and Klip et al [8] summarized the association between infertility and breast cancer and concluded that infertile women did not appear to be at higher risk for breast cancer. The possible influence of infertility itself on the risk of breast cancer occurrence should be taken into consideration [11]
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