Localized Fibroglandular Tissue as a Predictor of Future Tumor Location within the Breast.


Pereira, SM; McCormack, VA; Hipwell, JH; Record, C; Wilkinson, LS; Moss, SM; Hawkes, DJ; Dos Santos Silva, I; (2011) Localized Fibroglandular Tissue as a Predictor of Future Tumor Location within the Breast. Cancer epidemiology, biomarkers & prevention. ISSN 1055-9965 DOI: https://doi.org/10.1158/1055-9965.EPI-11-0423

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Abstract

BACKGROUND: Mammographic density (MD) is a strong marker of breast cancer risk, but it is unclear whether tumors arise specifically within dense tissue. METHODS: In 231 British women diagnosed with breast cancer after at least one negative annual screening during a mammographic screening trial, we assessed whether tumor location was related to localized MD 5 years prior to diagnosis. Radiologists identified tumor locations on digitised films. We used a validated algorithm to align serial images from the same woman to locate the corresponding point on the prediagnostic film. A virtual 1 cm square grid was overlaid on prediagnostic films and MD calculated for each square within a woman's breast (mean = 271 squares/film). Conditional logistic regression, matching on a woman's breast, was used to estimate the odds of a tumor arising in a square in relation to its prediagnostic square-specific MD. RESULTS: Median (interquartile range) prediagnostic MD was 98.2% (46.8%-100%) in 1 cm-squares that subsequently contained the tumor and 41.0% (31.5%-53.9%) for the whole breast. The odds of a tumor arising in a 1 cm-square were, respectively, 6.1 (95% CI: 1.9-20.1), 16.6 (5.2-53.2), and 25.5-fold (8.1-80.3) higher for squares in the second, third, and fourth quartiles of prediagnostic MD relative to those in the lowest quartile within that breast (P(trend) < 0.001). The corresponding odds ratios were 2.3 (1.3-4.0), 3.9 (2.3-6.4), and 4.6 (2.8-7.6) if a 3 cm-square grid was used. CONCLUSION: Tumors arise predominantly within the radiodense breast tissue. Impact: Localized MD may be used as a predictor of subsequent tumor location within the breast. Cancer Epidemiol Biomarkers Prev; 20(8); 1-8. ©2011 AACR.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 21693627
Web of Science ID: 293625600017
URI: http://researchonline.lshtm.ac.uk/id/eprint/374

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