Skip to main content

Advertisement

Springer Nature Link
Log in

Mammographic densities as a marker of human breast cancer risk and their use in chemoprevention

  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Differences in the parenchymal pattern of the breast on mammography reflect differences in the amounts of stromal, epithelial, and fat tissue present in the breast. Stroma and epithelium are radiologically dense, whereas fat is lucent. Extensive areas of mammographically dense breast tissue are strongly associated with an increased risk of breast cancer. A variety of interventions, including gonadotropin-releasing hormone inhibitor, tamoxifen, stopping hormone replacement therapy (HRT), and adopting a low-fat, high-carbohydrate diet, all influence the tissue composition of the breast and reduce mammographic densities. Of the interventions examined to date, only tamoxifen has been shown to reduce the incidence of breast cancer, at least in the short term. Conversely, HRT, which increases density, also increases risk of breast cancer. These results suggest that mammographic density may be a short-term marker of the effect on the breast of potential preventive interventions for breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Ingleby H, Gerson-Cohen J: Comparative Anatomy, Pathology and Roentgenology of the Breast. Philadelphia: University of Philadelphia Press; 1960.

    Google Scholar 

  2. Wolfe JN: Breast patterns as an index of risk for developing breast cancer. Am J Roentgenol 1976, 126:1130–1139.

    CAS  Google Scholar 

  3. Wolfe JN: Risk for breast cancer development determined by mammographic parenchymal pattern. Cancer 1976, 37:2486–2492.

    Article  PubMed  CAS  Google Scholar 

  4. Saftlas AF, Szklo M: Mammographic parenchymal patterns and breast cancer risk. Epidemiol Rev 1987, 9:146–174.

    PubMed  CAS  Google Scholar 

  5. Oza AM, Boyd NF. Mammographic parenchymal patterns: a marker of breast cancer risk. Epidemiol Rev 1993, 15:196–208.

    PubMed  CAS  Google Scholar 

  6. Boyd NF, O’Sullivan B, Campbell JE, et al.: Mammographic signs as risk factors for breast cancer. Br J Cancer 1982, 45:185–193.

    PubMed  CAS  Google Scholar 

  7. Brisson J, Merletti F, Sadowsky NL: Mammographic features of the breast and breast cancer risk. Am J Epidemiol 1982, 115:428–437.

    PubMed  CAS  Google Scholar 

  8. Brisson J, Morrison AS, Kopans DB: Height and weight, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 1984, 119:371–381.

    PubMed  CAS  Google Scholar 

  9. Brisson J, Verreault R, Morrison A, et al.: Diet, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 1989, 130:14–24.

    PubMed  CAS  Google Scholar 

  10. Wolfe JN, Saftlas AF, Salane M: Mammographic parenchymal patterns and quantitative evaluation of mammographic densities: a case-control study. Am J Roentgenol 1987, 148:1087–1092.

    CAS  Google Scholar 

  11. Saftlas AF, Hoover RN, Brinton LA, et al.: Mammographic densities and risk of breast cancer. Cancer 1991, 67:2833–2838.

    Article  PubMed  CAS  Google Scholar 

  12. Boyd NF, Byng JW, Jong RA, et al.: Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 1995, 87:670–675.

    Article  PubMed  CAS  Google Scholar 

  13. Byrne C, Schairer C, Wolfe J, et al.: Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst 1995, 87:1622–1629.

    Article  PubMed  CAS  Google Scholar 

  14. Kato I, Beinart C, Bleich A, et al.: A nested case-control study of mammographic patterns, breast volume, and breast cancer (New York City, NY, United States). Cancer Causes Contol 1995, 6:431–438.

    Article  CAS  Google Scholar 

  15. Easton DF, Ford D, Bishop DT: Breast cancer consortium: breast and ovarian cancer incidence in BRCA1-mutation carriers. Am J Hum Genet 1995, 56:265–271.

    PubMed  CAS  Google Scholar 

  16. Struewing JP, Hartge P, Wacholder S, et al.: The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N Engl J Med 1997, 336:1401–1408.

    Article  PubMed  CAS  Google Scholar 

  17. Grove JS, Goodman MJ, Gilbert F: Factors associated with mammographic pattern. Br J Radiol 1985, 58:21–25.

    Article  PubMed  CAS  Google Scholar 

  18. Grove JS, Goodman MJ, Gilbert FI, Clyde D. Factors associated with breast structures in breast cancer patients. Cancer 1979; 43:1895–1899.

    Article  PubMed  CAS  Google Scholar 

  19. Wolfe JN. Breast parenchymal patterns and their changes with age. Radiology 1976, 121:545–552.

    PubMed  CAS  Google Scholar 

  20. Boyd NF, Greenberg C, Lockwood G, et al.: Effects at two years of a low-fat, high-carbohydrate diet on radiologic features of the breast: results from a randomized trial. J Natl Cancer Inst 1997, 89:488–496.

    Article  PubMed  CAS  Google Scholar 

  21. Kaufman Z, Garstin WIH, Hayes R, et al.: The mammographic parenchymal patterns of nulliparous women and women with a family history of breast cancer. Clin Radiol 1991, 43:385–388.

    Article  PubMed  CAS  Google Scholar 

  22. Whitehead J, Carlile T, Kopecky KJ, et al.: The relationship between Wolfe’s classification of mammograms, accepted breast cancer risk factors, and the incidence of breast cancer. Am J Epidemiol 1985, 122:994–1006.

    PubMed  CAS  Google Scholar 

  23. Brisson J, Sadowski NL, Twaddle JA, et al.: The relation of mammographic features of the breast to breast cancer risk factors. Am J Epidemiol 1982, 115:438–443.

    PubMed  CAS  Google Scholar 

  24. Bergkvist L, Tabar L, Bergstrom R, Adami HO: Epidemiologic determinants of the mammographic parenchymal pattern: a population-based study within a mammographic screening program. Am J Epidemiol 1987, 126:1075–1081.

    PubMed  CAS  Google Scholar 

  25. Ernster VL, Sacks ST, Peterson CA: Mammographic parenchymal patterns and risk factors for breast cancer. Radiology 1980, 134:617–620.

    PubMed  CAS  Google Scholar 

  26. de Waard F, Rombach JJ, Collette HJA, Slotboom B: Breast cancer risk associated with reproductive factors and breast parenchymal patterns. J Natl Cancer Inst 1984, 72:1277–1282.

    PubMed  Google Scholar 

  27. Kelsey JL, Gammon MD, John ES: Reproductive factors and breast cancer. Epidemiol Rev 1993, 15:36–47.

    PubMed  CAS  Google Scholar 

  28. Pike MC, Krailo MD, Henderson BE, et al.: ‘Hormonal’ risk factors, ‘breast tissue age’ and the age-incidence of breast cancer. Nature 1983, 303:767–770.

    Article  PubMed  CAS  Google Scholar 

  29. Rosner B, Colditz G: Nurses’ Health Study: log-incidence mathematical model of breast cancer incidence. J Natl Cancer Inst 1996, 88:359–364.

    Article  PubMed  CAS  Google Scholar 

  30. Spicer D, Pike M, Lobo R, et al.: Gonadotropin hormone releasing hormone agonists <Gnrha> and prevention of familial breast cancer. Adv Cancer Control 1990, 339:193–199.

    CAS  Google Scholar 

  31. Ursin G, Astrahan MA, Salane M, et al.: The detection of changes in mammographic densities. Cancer Epidemiol Biomarkers Prev 1998, 7:43–47.

    PubMed  CAS  Google Scholar 

  32. Brisson J, Brisson B, Coté G, et al.: Tamoxifen and mammographic breast densities. Cancer Epidemiol Biomarkers Prev 2000, 9:911–915. Mammograms from subjects in the National Surgical Adjuvant Breast Project Cancer Prevention Trial showed a reduction in the number with high-risk breast patterns after 3 years of tamoxifen.

    PubMed  CAS  Google Scholar 

  33. Chow CK, Venzon D, Jones EC, et al.: Effect of tamoxifen on mammographic density. Cancer Epidemiol Biomarkers Prev 2000, 9:917–921. Mammograms from patients participating in a pilot study of tamoxifen and 4-HPR showed a decrease in high-risk appearance after 2 years of tamoxifen. Quantitative methods of assessing mammograms showed larger effects of tamoxifen than did qualitative approaches.

    PubMed  CAS  Google Scholar 

  34. Atkinson C, Warren R, Bingham SA, Day NE: Mammographic patterns as a predictive biomarker of breast cancer risk: effect of tamoxifen. Cancer Epidemiol Biomarkers Prev 1999, 8:863–866. Mammograms in postmenopausal women with breast cancer show reduction in high-risk appearance after treatment with tamoxifen.

    PubMed  CAS  Google Scholar 

  35. Lundström E, Wilczek B, von Palffy Z, et al.: Mammographic breast density during hormone replacement therapy: differences according to treatment. Am J Obstet Gynecol 1999, 181:348–352. Continuous combination hormone replacement therapy increases breast density more than does estrogen alone, or cyclical combination therapy.

    Article  PubMed  Google Scholar 

  36. Rutter CM, Mandelson MT, Laya MB, et al.: Changes in breast density associated with initiation, discontinuation, and continuing use of hormone replacement therapy. JAMA 2001, 285:171–176. Compared with non-users, women starting hormone replacement therapy are more likely to show an increase in mammographic density, and those stopping are more likely to show a decrease in density.

    Article  PubMed  CAS  Google Scholar 

  37. Freedman F, San Martin J, O’Gorman J, et al.: Digitized mammography: a clinical trial of postmenopausal women randomly assigned to receive raloxifene, estrogen, or placebo. J Natl Cancer Inst 2001, 93:51–56. In a randomized trial of prevention for osteoporosis, estrogen increased mammographic density, whereas raloxifene did not increase or decrease density.

    Article  PubMed  CAS  Google Scholar 

  38. Byrne C, Colditz GA, Willet WC, et al.: Plasma insulin-like growth factor (IGF) I, IGF-binding protein 3, and mammographic density. Cancer Res 2000, 60:3744–3748. A cross-sectional study in the cohort of the Nurses’ Health Study found higher blood levels of IGF-I to be associated with a greater degree of mammographic density.

    PubMed  CAS  Google Scholar 

  39. Wang DY, De Stavola BL, Bulbrook RD, et al.: The permanent effect of reproductive events on blood prolactin levels and its relation to breast cancer risk: a population study of postmenopausal women. Eur J Cancer Clin Oncol 1988, 24:1225–1231.

    Article  PubMed  CAS  Google Scholar 

  40. Reyes FI, Winter JSD, Faiman C: Pituitary-ovarian relationships preceding the menopause. Am J Obstet Gynecol 1977, 129:557–564.

    PubMed  CAS  Google Scholar 

  41. Andersen JR, Schroeder E, Lebech PE: The effect in postmenopausal women of natural human and artificial oestrogens on the concentration in serum of prolactin. Acta Endocrinol 1980, 95:433–437.

    PubMed  CAS  Google Scholar 

  42. Fisher B, Costantino JP, Wickerham DL, et al.: Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998, 90:1371–1388.

    Article  PubMed  CAS  Google Scholar 

  43. Collaborative Group on Hormonal Factors in Breast Cancer: Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Lancet 1997, 350:1047–1059.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Epidemiology and Statistics, Ontario Cancer Institute, Room 10-415, 610 University Avenue, M5G 2M9, Toronto, ON, Canada

    Norman F. Boyd MD, DSc, FRCPC, Lisa J. Martin MSc, Jennifer Stone MSc, Cary Greenberg BASc, Salomon Minkin PhD & Martin J. Yaffe PhD

Authors
  1. Norman F. Boyd MD, DSc, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa J. Martin MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennifer Stone MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cary Greenberg BASc
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Salomon Minkin PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Martin J. Yaffe PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Boyd, N.F., Martin, L.J., Stone, J. et al. Mammographic densities as a marker of human breast cancer risk and their use in chemoprevention. Curr Oncol Rep 3, 314–321 (2001). https://doi.org/10.1007/s11912-001-0083-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-001-0083-7

Keywords

Search

Navigation