Abstract
Variations in percent mammographic density (PMD) reflect variations in the amounts of collagen and number of epithelial and non-epithelial cells in the breast. Extensive PMD is associated with a markedly increased risk of invasive breast cancer. The PMD phenotype is important in the context of breast cancer prevention because extensive PMD is common in the population, is strongly associated with risk of the disease, and, unlike most breast cancer risk factors, can be changed. Work now in progress makes it likely that measurement of PMD will be improved in the near future and that understanding of the genetics and biological basis of the association of PMD with breast cancer risk will also improve. Future prospects for the application of PMD include mammographic screening, risk prediction in individuals, breast cancer prevention research, and clinical decision making.
Highlights
Breast density, assessed by mammography and expressed as a percentage of the mammogram occupied by radiologically dense tissue, reflects variations in breast tissue composition and is strongly associated with breast cancer risk [1]
We review the evidence that percent mammographic density (PMD) is a risk factor for breast cancer, histological and other factors associated with variations in PMD, and the biological plausibility of the associations with risk of breast cancer
Mammographic density has been the subject of a meta-analysis [1] and a recent review [2] and readers are referred to these sources for additional information
Summary
Breast density, assessed by mammography and expressed as a percentage of the mammogram occupied by radiologically dense tissue (percent mammographic density, or PMD), reflects variations in breast tissue composition and is strongly associated with breast cancer risk [1]. Mammographic density and risk of breast cancer The radiographic appearance of the breast on mammography varies among women, as illustrated, and reflects variations in breast tissue composition and the different x-ray attenuation characteristics of these tissues [3]. Connective and epithelial tissues are radiologically dense and appear light. This appearance is usually expressed as a percentage of the breast area, or (as referred to here) as percent mammographic density (PMD)
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