Breast Cancer Risk Research Articles

Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women

BackgroundEach breast cancer (BC) risk factor has different effects on different populations. However, there are no well-studied and validated BC risk prediction models for Japanese women. We developed accessible predictive models for Japanese women with optimal variables to evaluate risk factors for use by both medical institutions and women for primary BC prevention and to increase the BC screening rate. We evaluated the characteristics and distribution diversity of risk factors in this population.MethodsThis retrospective case–control study of 2,494 Japanese women included data from an original, paper-based questionnaire. The logistic regression models included 18 variables from 6 risk factors based on menopausal status (PRE, premenopausal; PERI, perimenopausal; and POST, postmenopausal). Models were evaluated based on the Akaike Information Criterion, area under the receiver operating characteristic curve (AUC), and internal validation. Bootstrap methods for bias correction in discrimination and calibration and standard deviations were calculated by the modified case–control ratio.ResultsWe created and evaluated 432 candidate models for each group. Notably, BMI, parity, FHx, and smoking history were found to increase risk in all groups. Risk-reducing factors included breastfeeding duration in the PRE and PERI models and regular alcohol consumption in the PERI and POST models. Age reduced risk in the PERI model but increased risk in the POST model. Differences were observed between PRE and PERI versus POST with respect to variable selection in parity and FHx. Our models had moderate discriminatory accuracy. AUCs (confidence intervals) of the PRE, PERI, and POST models were 0.669 (0.625–0.715), 0.669 (0.632–0.702), and 0.659 (0.627–0.693), respectively. Bias-corrected AUCs (standard deviations) were 0.697 (0.041) for PRE, 0.684 (0.033) for PERI, and 0.674 (0.031) for POST, respectively. Our models were well-calibrated after bias correction.ConclusionOur widely available, simple, and cost-effective models with optimal variables could indicate the characteristics of certain genetic and environmental risk factors for BC in Japanese women.

Socioeconomic and Geographic Differences in Mammography Trends Following the 2009 USPSTF Policy Update.

In 2024, the US Preventive Services Task Force (USPSTF) reversed a 2009 policy recommending only females aged 50 to 74 years complete a biennial mammogram. Understanding whether females facing heterogeneous breast cancer risks responded to the 2009 guidance may illuminate how they may respond to the latest policy update. To evaluate whether the 2009 policy was associated with changes in mammography screening in females no longer recommended to complete a biennial mammogram and whether these changes varied by factors associated with breast cancer risk. The difference-in-differences design compared biennial mammogram trends in the exposed groups (aged 40-49 and ≥75 years) with trends of the unexposed groups (aged 50-64 and 65-74 years), before and after the 2009 update. Population-based, repeated cross-sectional survey data came from the Behavioral Risk Factor Surveillance System (BRFSS) biennial cancer screening module (2000-2018). The sample was restricted to females between ages 40 and 84 years. Data were analyzed from March 1 to June 30, 2024. The outcome was a binary variable indicating whether the respondent reported a mammogram in the past 2 years (biennial). After 2009, females aged 40 to 49 and 75 or older years were exposed to the policy update, as a complete biennial mammogram was recommended. Subgroup analyses included race and ethnicity, educational level, household income, smoking history, current binge drinking status, and state of residence. The sample included 1 594 834 females; 75% reported a biennial mammogram. In those aged 40 to 49 years, the USPSTF update was associated with a 1.1 percentage-point (95% CI, -1.8% to -0.3 percentage points) decrease in the probability of a biennial mammogram, with the largest decreases in the non-Hispanic Black population (-3.0 percentage points; 95% CI, -5.5% to -0.5 percentage points). In the aged 75 years or older group, the USPSTF update was associated with a 4.8 percentage-point decrease (95% CI, -6.3% to -3.5 percentage points) in the probability of a biennial mammogram, with significant heterogeneity by race and ethnicity, binge drinking status, and state residence. In this study, socioeconomic factors were associated with differences in how females responded to the 2009 USPSTF mammography recommendation. Whether the 2024 update considered such differences is unclear. These findings suggest that including risk assessment into future USPSTF policy updates may improve adoption of risk-reducing interventions and shorten the time to diagnosis and treatment for high-risk patients.

Chan-Vese aided fuzzy C-means approach for whole breast and fibroglandular tissue segmentation: Preliminary application to real-world breast MRI.

Magnetic resonance imaging (MRI) is a highly sensitive modality for diagnosing breast cancer, providing an expanding range of clinical usages that are crucial for the care of women at elevated risk of breast cancer development. Segmentation of the whole breast and fibroglandular tissue (FGT), used to evaluate breast cancer risk, is often manually delineated by radiologists in clinical practice. In this paper, we aim to substitute handcrafted breast density segmentation and categorization. The traditional fuzzy C-means (FCM) enable automatic segmentation but may be susceptible to heterogeneity or sparse FGT distribution in MRI. We develop a new automated technique for the segmentation of whole breast and FGT for the coronal-view MRI. We propose a Chan-Vese (CV) aided FCM segmentation approach for estimating the FGT in the whole breast using fat-suppressed (FS) precontrast T1-weighted breast MRI. We present a methodology pipeline comprising region-of-interest (ROI) extraction, nonparametric non-uniform intensity normalization N4 algorithm-based intensity inhomogeneity correction, skin-layer extraction, and then whole breast and FGT segmentation. Our approach involves the FCM algorithm to assign membership degrees to pixels, distinguishing FGT regions from surrounding adipose tissues by assessing their probability of belonging to specific FGT regions, and subsequently, the region-based active contour CV model leverages these membership degrees to direct contour evolution and enhance segmentation boundaries. The proposed method adeptly tackles common challenges in MRI, including blurred edges, low contrast, and intensity inhomogeneity, with efficiency. We evaluated our approach on the Duke Breast Cancer MRI data (DBCM-data) and achieved good segmentation accuracy in terms of Dice similarity coefficient (DSC), Intersection-over-Union (IoU), and Sensitivity (SEN). Our method demonstrates significant accuracy, achieving a DSC (%) of 93.2 ± 3.3 and 84.1 ± 4.9, IoU (%) of 86.4 ± 3.5 and 73.2 ± 5.1, and SEN 87.3 ± 4.1 and 76.7 ± 4.1 for the segmentations of whole breast and FGT, respectively. Our results demonstrated that the CV-aided FCM approach significantly outperformed the existing methods and resulted in significantly more accurate whole breast and FGT segmentation in MRI data.

Breast Cancer Risk and Management in the Endocrine Clinic: A Comprehensive Review.

This review seeks to provide endocrine clinicians with a comprehensive analysis of breast cancer risk, diagnostic modalities and management strategies in women with endocrine disorders, with particular emphasis on the influence of metabolic factors such as diabetes and obesity, and the role of Menopausal Hormone Therapy (MHT). The review examines a spectrum of endocrine disorders commonly encountered in clinical practice, including Multiple Endocrine Neoplasia Types 1 (MEN1), 2 (MEN2) and 4 (MEN4), Von Hippel-Lindau syndrome (VHL), Pheochromocytoma and Paraganglioma (PPGL), Acromegaly, Hyperprolactinaemia, Polycystic Ovary Syndrome (PCOS), Congenital Adrenal Hyperplasia (CAH), Turner Syndrome, alongside metabolic conditions such as diabetes and obesity and the effects of MHT. The review critically appraises each disorder's association with breast cancer risk, screening implications and therapeutic management. This analysis focuses on women with the aforementioned endocrine and metabolic disorders, assessing their specific breast cancer risk profiles, informed by the latest clinical evidence and molecular insights. The review comprehensively evaluates current evidence-based approaches to screening, diagnostic accuracy and treatment in this patient cohort. Emphasis is placed on the metabolic derangements, hormonal influences and genetic predispositions that modulate breast cancer risk, providing disorder-specific recommendations for individualised care. The findings indicate a significantly elevated breast cancer risk in patients with MEN1, necessitating early initiation of MRI screening by age 40. In MEN2, emerging evidence suggests that combining RET inhibitors with endocrine therapy may yield clinical benefits, although further research is needed to validate this approach. The breast cancer risk associated with MEN4 and VHL syndromes, while documented, remains less well-characterised, requiring further investigation. Diabetes and obesity are confirmed as major modifiable risk factors, particularly in postmenopausal women, where hyperinsulinemia and metabolic dysfunction contribute to increased incidence and poorer outcomes, notably in triple-negative breast cancer (TNBC). The role of MHT, particularly combined oestrogen-progestogen therapy, is strongly associated with increased breast cancer risk, particularly for hormone receptor-positive malignancies, necessitating cautious use and personalised treatment planning. In contrast, oestrogen-only MHT appears to confer a reduced risk in women post-hysterectomy. For patients with PCOS, CAH and Turner Syndrome, while definitive evidence of elevated breast cancer risk is lacking, individualised screening strategies and careful hormone therapy management remain essential due to the complex interplay of hormonal and metabolic factors. The review highlights the need for personalised breast cancer screening and management protocols in women with endocrine and metabolic disorders. For high-risk groups such as MEN1 patients, early initiation of MRI screening is warranted. In women with diabetes and obesity, targeted interventions addressing hyperinsulinemia and metabolic dysfunction are critical to mitigating their increased cancer risk. The association between MHT and breast cancer underscores the importance of individualised risk stratification in hormone therapy administration, particularly in women with predisposing genetic or endocrine conditions. Enhanced surveillance tailored to the unique risk profiles of endocrine disorder patients will facilitate early detection and improve clinical outcomes. However, further large-scale studies are necessary to refine these associations and develop robust, evidence-based guidelines.

Lifestyle Factors and Family History of Diabetes as Significant Risks for Breast Cancer: A Hospital-Based Cohort Study in Tamil Nadu, India

Lifestyle Factors and Family History of Diabetes as Significant Risks for Breast Cancer: A Hospital-Based Cohort Study in Tamil Nadu, India

Associations between phenol and paraben exposure and the risk of developing breast cancer in adult women: a cross-sectional study

Increasing evidence suggests that endocrine-disrupting chemicals (EDCs) have adverse effects on breast cancer (BC). The aim of this study was to assess the association between exposure to prevalent EDCs—phenols and parabens—and the risk of developing BC. Data on urinary bisphenol A (BPA), triclosan (TRS), benzophenone-3 (BP3), methyl paraben (MPB), ethyl paraben (EPB), propyl paraben (PPB), and butyl paraben (BUP) were obtained from the 2005–2014 National Health and Nutrition Examination Survey. A total of 4455 subjects were included in this cross-sectional study. The results from the weighted multivariable regression models indicated that exposure to elevated concentrations of TRS increased the risk of developing BC by 2.33 (Q2: 95% CI = 1.45–3.75, p < 0.001) and 1.94 times (Q3: 95% CI = 1.21–3.09, p = 0.006), respectively. The nonlinear association between TRS concentrations and the risk of developing BC was statistically significant (P nonlinear = 0.007), with the restricted cubic splines (RCS) curve exhibiting an inverted U shape. The association between TRS concentrations and the risk of developing BC was more pronounced among overweight individuals (BMI ≥ 25 kg/m2), those aged < 60 years, and white individuals. Weighted quantile sum (WQS) and Bayesian Kernel Machine Regression (BKMR) analysis revealed no significant overall association between mixtures of urinary phenol and paraben metabolites and BC risk. However, TRS exposure was the most influential, with higher TRS concentrations (both continuous and categorical) significantly associated with an increased BC risk, particularly in overweight individuals (BMI ≥ 25 kg/m2), those aged < 60 years, and white individuals.

Susceptibility of Brca1(L63X/+) rat to ovarian reserve dissipation by chemotherapeutic agents to breast cancer.

BRCA1 is one of the causative genes for hereditary breast and ovarian cancer syndrome with a high risk of early-onset breast cancer. Whereas olaparib (OLA), an inhibitor of poly-ADP-ribose polymerase, has been applied as adjuvant therapy to those cancer patients, its effect on ovarian reproductive function remains unelucidated. Recently, a rat model (MUT; Brca1(L63X/+) mutation) mimicking a human BRCA1 pathogenic variant has been established. Using this model, we evaluated the effects of OLA on ovarian reproductive function in comparison with the wild-type (WT) rats. MUT showed a significantly reduced number of primordial follicles and subfertility in accordance with aging. Oxidative stress was significantly elevated in the young MUT granulosa cells (GCs) accompanied by increased mTOR but decreased PTEN signals. OLA administration in MUT further decreased primordial follicles, with gene set enrichment analysis, indicating upregulated DNA repair pathways. Furthermore, a combination of OLA and cyclophosphamide (CPA) induced empty primordial follicles, recognized as CPA-induced severe ovarian toxicity. Whereas OLA + CPA caused greater reduction in primordial follicles both in MUT and WT in comparison with CPA alone, MUT ovaries were more susceptible to oxidative stress, potentially depleting primordial follicles via activation of GCs and inducing oocyte death due to accumulated DNA damage by OLA treatment. Our findings in this preclinical model underscore the importance of evaluating ovarian reserve prior to chemotherapy by performing reproductive consultation with female patients with BRCA1 pathogenic variants.

Patient perspective: Is intensive screening of women at high risk of breast cancer evidence-based medicine or déjà vu?

In 2023, a breast cancer risk assessment and a subsequent positive test for the BRCA-2 genetic mutation brought me to the uncomfortable intersection of a longstanding career as an advocate for high-quality medical evidence to support shared patient-provider decision making and a new role as a high-risk patient. My search for studies of available risk-management options revealed that the most commonly recommended approach for women with a ⩾20% lifetime breast cancer risk, intensive screening including annual mammography and/or magnetic resonance imaging beginning at age 25-40 years, was supported only by cancer-detection statistics, with almost no evidence on patient-centered outcomes-mortality, physical and psychological morbidity, or quality of life-compared with standard screening or a surgical alternative, bilateral risk-reducing mastectomy. In this commentary, I explore parallels between the use of the intensive screening protocol and another longstanding women's health recommendation based on limited evidence, the use of hormone therapy (HT) for postmenopausal chronic disease prevention, which was sharply curtailed after the publication of the groundbreaking Women's Health Initiative trial in 2002. These declines in HT utilization were followed by marked decreases in breast cancer incidence, providing a compelling lesson on the critical importance of a solid evidentiary basis for women's health decisions. Known harms accompanying the benefits of breast screening-overdiagnosis, psychological effects, and mammography-associated radiation-exposure risks-make empirical measurement of patient-centered outcomes essential. Yet, published research on intensive screening of women at high breast cancer risk has largely ignored these outcomes, leaving patients, providers, and guideline developers lacking the evidence needed for best practice. Outcomes research is both feasible and urgently needed to inform care decisions and health policy for this patient population.

Effects of endocrine disrupting chemicals, blood metabolome, and epigenetics on breast cancer risk: A multi-dimensional mendelian randomization study.

Current research on the relationship between environmental endocrine disrupting chemicals (EDCs) and breast cancer remains insufficient, with limited evidence and inconsistent conclusions. Mendelian randomization (MR) is a robust method for establishing causality, as it reduces biases from confounding factors and reverse causation. This study uses MR to investigate the effects of three types of EDCs, including bisphenols, parabens, and phthalates, on the risk of overall breast cancer and its subtypes-Luminal A, Luminal B, triple negative, human epidermal growth factor receptor 2-enriched, and estrogen receptor-positive/negative. The study also examines the 1400 blood metabolome as potential mediators and explores EDCs-associated DNA methylation changes as potential factors, with a focus on European populations. Our results shows that n-butyl paraben (n-BuP) is positively associated with Luminal A, mono-methyl phthalate is negatively associated with Luminal B, and mono-iso-butyl phthalate (MiBP) is positively associated with triple negative breast cancer (TNBC). Mediation analysis reveals that blood metabolites, such as caffeic acid sulfate and the caffeine-to-paraxanthine ratio, mediate the effect of n-BuP on Luminal A, while methylsuccinate mediate the effect of MiBP on TNBC. Epigenetic analysis shows associations between EDCs exposure-related DNA methylation changes at specific CpG sites (cg26325335, cg08537847, cg27454300) and different breast cancer risks. These findings not only suggest potential biomarkers for early detection and intervention but also underscore the imperative for further research to rigorously validate these associations.

Understanding the relationship between silicone implants, tumor antigens, and breast cancer risk: An immunological study in rats.

This study aimed to investigate the effects of silicone implants on the incidence of breast cancer in rats, as well as their impact on immune surveillance mechanisms. Female SD rats were divided into three groups: a Placebo Surgery Group (PSG), a Thoracic Implant Group (TIG), and a Back Implant Group (BIG). Following the corresponding surgical procedures, we measured Secretoglobin Family 2A, Member 2(SCGB2A2) and Mucin-1 (MUC1) antigen levels using ELISA, and statistical analyses were conducted to evaluate immune responses. The N-Methyl-N-Nitrosourea(MNU)-induced breast cancer model and pathological analyses indicated that the incidence of breast cancer in the thoracic implant group was lower, suggesting that silicone implants may reduce the risk of breast cancer. Additionally, laser speckle blood flow imaging and immunohistochemical analysis revealed blood perfusion in the implant capsule area and an active response of immune cells, indicating that immune surveillance may exert local effects. These findings provide the first evidence of a relationship between tumor antigens, silicone implants, and breast cancer incidence, offering a new immunological perspective on the safety of silicone implants.

Using AI to Select Women with Intermediate Breast Cancer Risk for Breast Screening with MRI.

Background Combined mammography and MRI screening is not universally accessible for women with intermediate breast cancer risk due to limited MRI resources. Selecting women for MRI by assessing their mammogram may enable more resource-effective screening. Purpose To explore the feasibility of using a commercial artificial intelligence (AI) system at mammography to stratify women with intermediate risk for supplemental MRI or no MRI. Materials and Methods This retrospective study included consecutive women with intermediate risk screened with mammography and MRI between January 2003 and January 2020 at a Dutch university medical center. An AI system was used to independently evaluate all mammograms, providing a case-based score that ranked the likelihood of a malignancy on a scale of 1-10. Different AI thresholds for supplemental MRI screening were tested, balancing cancer detection against the number of women needing to undergo MRI. Univariate analyses were used to explore associations between personal factors (age, breast density, and duration of screening participation) and AI results. Results In 760 women (mean age, 48.9 years ± 10.5 [SD]), 2819 combined screening examinations were performed, and 37 breast cancers were detected. Use of AI at mammography achieved an area under the receiver operating characteristic curve of 0.72 (95% CI: 0.63, 0.81) for the entire intermediate-risk population and 0.81 (95% CI: 0.69, 0.93) for women with prior breast cancer. Using a threshold score of 5, 31 of 37 (84%) breast cancers were detected, including 13 of 19 (68%) mammographically occult cancers, at a supplemental breast MRI rate of 50% (1409 of 2819 examinations). No significant association between breast density or age and the probability of a false-negative AI result was found. Conclusion Using AI at mammography to select women for supplemental MRI effectively identified women with higher breast cancer risk in an intermediate-risk population, including women with mammographically occult cancers. AI selection of women with intermediate risk for supplemental MRI screening has the potential to reduce screening burden and costs, while maintaining a high cancer detection rate. © RSNA, 2025.

A 20-year population-wide cohort study on association of aspirin and risk of gastrointestinal and non-gastrointestinal cancer.

830 Background: Aspirin has been shown to reduce the risk of various gastrointestinal (GI) and non-GI cancers 1,2 . However, little was known about at what age aspirin should be started for maximal chemoprotective better on GI cancer. Furthermore, the randomised controlled trial on aspirin for primary prevention use in healthy elderly (ASPREE) showed no association between aspirin and cancer incidence despite the limitation of short follow-up duration 3 . The current study aims to investigate the 20-year risk of cancer using aspirin in a territory-wide Hong Kong population cohort. Methods: The study included all aspirin users from 2000 to 2019, and non-aspirin users matched by age and sex at a ratio of 1:2. Enrolled subjects with a history of cancer at enrolment, cancer incidence or death within 6 months were excluded. The incidence of individual GI and non-GI cancer was presented as the primary outcome. Baseline characteristics between aspirin and non-aspirin users were adjusted in the survival analysis by inverse probability of treatment weighting (IPTW). The fine-grey model has been used to address bias from competing risk of death. The sub-distribution hazard ratio was presented for the association of aspirin use and risk of GI and non-GI cancers. Results: The current study included 538,147 aspirin users and 968,378 non-users with a mean age of 64.8 years. A total number of 36,683 cases of GI cancer (2.4%) and 47,196 cases of non-GI cancers (3.1%) were observed. Aspirin was associated with a lower risk of several common individual GI cancers, including colorectal cancer (SHR 0.78, 95% CI 0.76-0.81), liver cancer (SHR 0.67, 95% CI 0.64-0.70), stomach cancer (SHR 0.79, 95% CI 0.75-0.84) and pancreatic cancer (SHR 0.85, 95% CI 0.79-0.91), but not oesophageal cancer. On the other hand, aspirin was associated with a lower risk of prostate cancer (SHR 0.95, 95% CI 0.91-1.00) and breast cancer (SHR 0.76, 95% CI 0.73-0.79), but not lung cancer and kidney cancer. In overall, aspirin was associated with a 24% lower risk of GI cancers (SHR 0.76, 95% CI 0.74-0.78) and a 3% lower risk of non-GI cancers (SHR 0.97, 95% CI 0.95-0.99). Conclusions: Aspirin was associated with a lower risk of most GI cancers, including colorectal cancer, liver cancer, stomach cancer and pancreatic cancer, but not most non-GI cancers. In general, results on the effect of aspirin on GI cancer prevention were consistent with the previously presented 10-year cohort. 1. Bosetti C, Santucci C, Gallus S, Martinetti M, La Vecchia C. Aspirin and the Risk of Colorectal and Other Digestive Tract Cancers: An Updated Meta-analysis through 2019. Ann Oncol. 2020;31(5):558-568. 2. Santucci C, Gallus S, Martinetti M, La Vecchia C, Bosetti C. Aspirin and the risk of nondigestive tract cancers: An updated meta-analysis to 2019. Int J Cancer. 2021;148(6):1372-1382. 3. McNeil JJ, Gibbs P, Orchard SG, et al. Effect of Aspirin on Cancer Incidence and Mortality in Older Adults. J Natl Cancer Inst. 2021;113(3):258-265.

False-Negative Review from the Mammography Audit: Refining Breast Imaging Practice.

Annual review of false-negative (FN) mammograms is a mandatory and critical component of the Mammography Quality Standards Act (MQSA) annual mammography audit. FN review can help hone reading skills and improve the ability to detect cancers at mammography. Subtle architectural distortion, asymmetries (seen only on one view), small lesions, lesions with probably benign appearance (circumscribed regular borders), isolated microcalcifications, and skin thickening are the most common mammographic findings when the malignancy is visible at retrospective review of FN mammograms. Most FN mammograms are not due to radiologist error. There are common and predictable settings in which FN mammograms occur. Patient factors associated with elevated FN mammograms include dense breasts, elevated lifetime risk of breast cancer, and personal history of breast cancer treated with lumpectomy and radiation therapy. About half of FN cancers are detected by supplemental screening examinations and half manifest clinically. The most common manifesting symptoms for interval cancers are a palpable abnormality, nipple discharge, and skin changes. Interval cancers can have more aggressive pathologic features and higher rates of node positivity. The FN review includes Breast Imaging Reporting and Data System (BI-RADS) 3 cases that develop a cancer diagnosis during surveillance. Nonbreast malignancies diagnosed as interval cancers (most commonly lymphoma and metastatic disease) do not need to be counted as FNs for audit purposes. The FN review and annual audit are confidential processes that protect patient and radiologist information while allowing meaningful quality control and improvement. Although FN mammograms are rare, review of these cases is a valuable educational tool. The slide presentation from the RSNA Annual Meeting is available for this article. ©RSNA, 2025.

Associations of early life body size and pubertal timing with breast density and postmenopausal breast cancer risk: A mediation analysis.

Whether breast density mediates associations between early life body size and pubertal timing with postmenopausal breast cancer is underexplored. We studied 33,939 Danish women attending the Capital Mammography Screening Program at ages 50-69 years. Early life anthropometry and pubertal timing information came from the Copenhagen School Health Records Register. Postmenopausal breast cancer information came from the Danish Breast Cancer Group database (n = 833). Breast density (BI-RADS) was categorized as low (n = 25,464; 75 %) or high. Risk ratios (RR) and hazard ratios (HR) were estimated using generalized linear regression and Cox proportional hazards analyses. Counterfactual mediation analyses were conducted. Evidence was limited for associations between birthweight and pubertal timing with breast density or breast cancer. Childhood BMI was inversely associated with high breast density (age 13y, RR=0.77 [0.72-0.81] for a z-score of 0.6 versus 0) and breast cancer (HR=0.90 [0.83-0.96] per z-score). Breast density mediated 37 % (17-170 %) of this association. Although childhood height was associated with breast density and breast cancer, there were few indications of mediation by breast density. Breast density may partially explain the inverse association between childhood BMI and postmenopausal breast cancer, but not the positive association between childhood height and postmenopausal breast cancer.

A review of gadolinium-based contrast agents in the setting of repeated MRI for high risk breast cancer screening

A review of gadolinium-based contrast agents in the setting of repeated MRI for high risk breast cancer screening

Effect of weight loss following Roux-en-Y gastric bypass on cancer risk: A Mendelian randomization study.

Cancer incidence and development are strongly correlated with obesity, however there is insufficient data to support a causal relationship between intentional weight loss and the prevention or promotion of cancer. We investigated the causal relationship between weight loss following Roux-en-Y gastric bypass (RYGB) and the incidence of 18 cancers using Mendelian randomization (MR). A genome-wide association studies (GWAS) data related to weight loss following RYGB from the GWAS catalog database were used as exposure, and GWAS data related to 18 cancers from the Medical Research Council integrative epidemiology unit open GWAS project were used as outcomes. In order to investigate the causal relationship between exposure and results, we used a two-sample MR approach. The primary analysis technique was inverse variance weighting, with weighted median, and MR-Egger regression utilized as supplemental techniques to confirm the findings. Heterogeneity and horizontal pleiotropy were investigated using a variety of sensitivity studies, including the Cochran Q test, MR-Egger regression pleiotropy test, MR pleiotropy residual sum and outlier, and leave-one-out analysis. We included a total of 4 single-nucleotide polymorphisms as instrumental variables through rigorous quality control screening. Under the limitations of Bonferroni correction threshold (P < 2.78 × 10-3), our results suggest that the weight loss following RYGB has a significant causal relationship with a reduced risk of breast (odds ratio [OR]: 0.784; 95% confidence interval [CI]: 0.762-0.808; P = 2.167e-58) and lung cancer (OR: 0.992; 95% CI: 0.987-0.997; P = .0023), and a potential causal relationship with a decreased risk of hematological cancer (OR: 0.9998462; 95% CI: 0.9997088-0.9999836; P = .028) and an increased risk of cervical cancer (OR: 1.000123; 95% CI: 1.0000313-1.000215; P = .009). Sensitivity analysis confirms the robustness of our analysis results. Genetically predicted weight loss following RYGB has significant causal effects in reducing the risk of breast and lung cancer. It also has potential benefits in lowering the risk of hemotological cancers and increasing the risk of cervical cancer. Considering the limitations of our study, the reliability of its results and the underlying mechanisms require further investigation.

Adjuvant Tamoxifen Alone May Reduce Recurrence Risk in Breast Cancer

Adjuvant Tamoxifen Alone May Reduce Recurrence Risk in Breast Cancer

3 QUESTIONS ON . . . The Role of Air Pollution in Breast Cancer Risk

3 QUESTIONS ON . . . The Role of Air Pollution in Breast Cancer Risk

Development of a novel risk signature revealing prognostic and tumor microenvironmental features in breast cancer.

This study aimed to devise a breast cancer (BC) risk signature for based on pyrimidine metabolism-related genes (PMRGs) to evaluate its prognostic value and association with drug sensitivity. Transcriptomic and clinical data were retrieved from The Cancer Genome Atlas database and Gene Expression Omnibus repository. Pyrimidine metabolism-associated genes were identified from the Molecular Signatures Database collection. A risk signature was constructed through Cox regression and Lasso regression methods. Further, the relationship between the PMRG-derived risk feature and clinicopathological characteristics, gene expression patterns, somatic mutations, drug susceptibility, and tumor immune microenvironment was thoroughly investigated, culminating in the development of a nomogram. PMRGs displayed differential expression and diverse somatic mutations in BC. Univariate Cox analysis identified 36 genes significantly associated with BC prognosis, leading to the categorization of 2 BC molecular subtypes with discernible differences in prognosis. Using Lasso Cox regression, a risk signature composed of 16 PMRGs was established, wherein high-risk scores were indicative of poor prognosis. The PMRG-derived risk feature was also related to chemotherapy regimens and showed significant correlations with sensitivity to multiple drugs. Furthermore, distinct tumor immune microenvironment properties, gene expression profiles, and somatic mutation patterns were evident across varying risk scores. Ultimately, a nomogram was constructed incorporating the PMRGs-based risk signature alongside stage, and chemotherapy status, demonstrating excellent performance in prognosis prediction. We successfully developed a PMRG-based BC risk signature that effectively combines with clinicopathological attributes for accurate prognosis assessment in BC.

Observational study on Lifestyle Behaviours and Nutrition in individuals undergoing genetic counseling for breast or colorectal cancer risk

Observational study on Lifestyle Behaviours and Nutrition in individuals undergoing genetic counseling for breast or colorectal cancer risk