Abstract
IntroductionHigh weight and high percentage mammographic breast density are both breast cancer risk factors but are negatively correlated. Therefore, we wanted to obtain more insight into this apparent paradox.MethodsWe investigated in a longitudinal study how weight change over menopause is related to changes in mammographic breast features. Five hundred ninety-one participants of the EPIC-NL cohort were divided into three groups according to their prospectively measured weight change over menopause: (1) weight loss (more than ā3.0 %), (2) stable weight (between ā3.0 % and +3.0 %), and (3) weight gain (more than 3.0 %). SPSS GLM univariate analysis was used to determine both the mean breast measure changes in, and the trend over, the weight change groups.ResultsOver a median period of 5 years, the mean changes in percent density in these groups were ā5.0 % (95 % confidence interval (CI) ā8.0; ā2.1), ā6.8 % (95 % CI ā9.0; ā4.5), and ā10.2 % (95 % CI ā12.5; ā7.9), respectively (P-trend = 0.001). The mean changes in dense area were ā16.7 cm2 (95 % CI ā20.1; ā13.4), ā16.4 cm2 (95 % CI ā18.9; ā13.9), and ā18.1 cm2 (95 % CI ā20.6; ā15.5), respectively (P-trend = 0.437). Finally, the mean changes in nondense area were ā6.1 cm2 (95 % CI ā11.9; ā0.4), ā0.6 cm2 (95 % CI ā4.9; 3.8), and 5.3 cm2 (95 % CI 0.9; 9.8), respectively (P-trend < 0.001).ConclusionsGoing through menopause is associated with a decrease in both percent density and dense area. Owing to an increase in the nondense tissue, the decrease in percent density is largest in women who gain weight. The decrease in dense area is not related to weight change. So the fact that both high percent density and high weight or weight gain are associated with high postmenopausal breast cancer risk can probably not be explained by an increase (or slower decrease) of dense area in women gaining weight compared with women losing weight or maintaining a stable weight. These results suggest that weight and dense area are presumably two independent postmenopausal breast cancer risk factors.
Highlights
High weight and high percentage mammographic breast density are both breast cancer risk factors but are negatively correlated
Body mass index (BMI), and adult weight gain are associated with a higher postmenopausal breast cancer risk [4,5,6]
Our study population was comparable to the total group of Prospect-European Prospective Investigation into Cancer and Nutrition (EPIC) participants who went through menopause after baseline but before the first follow-up questionnaire with regard to age and weight at baseline and weight change
Summary
High weight and high percentage mammographic breast density are both breast cancer risk factors but are negatively correlated. Percent density, which is determined by dividing the absolute dense area by the total breast area, multiplied by 100, High weight, body mass index (BMI), and adult weight gain are associated with a higher postmenopausal breast cancer risk [4,5,6]. Higher weight and BMI are associated with lower percent density since the measures of adiposity are associated with a higher breast fat content, resulting in a lower proportion of Wanders et al Breast Cancer Research (2015) 17:74 Page2of mammographic dense tissue [7,8,9]. High weight and high mammographic percent density are both associated with higher postmenopausal breast cancer risk, they are inversely associated with each other [9,10,11,12,13,14]
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