Korean J Fam Pract. 2017; 7(3): 348-352  https://doi.org/10.21215/kjfp.2017.7.3.348
Factors Affecting Mammographic Density in Korea Women Older Than 40 Years
Yeon-Hui Lee1, Min-Kyu Han1,*, Woo-Sung Lee1, Jin-Woo Park2
1Department of Family Medicine, Daerim Saint Mary’s Hospital, Seoul; 2Department of Family Medicine, Daesung Medical Center, Bucheon, Korea
Min-Kyu Han
Tel: +82-2-829-8350, Fax: +82-2-829-9320
E-mail: ilovebeeth@gmail.com
Received: March 10, 2016; Revised: September 9, 2016; Accepted: September 17, 2016; Published online: June 20, 2017.
© Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: A dense mammogram is a risk factor of breast cancer and is associated with decreased mammographic sensitivity and specificity. The purpose of this study was to evaluate several factors that influence mammographic density in Korean women. Furthermore, we considered the effectiveness of mammography as a screening method for breast cancer.
Methods: The study subjects were 3,013 women older than 40 years who underwent screening mammography between January 2, 2015, and October 31, 2015, at health promotion centers. We classified breast density patterns as either non-dense or dense by using the Breast Imaging Reporting and Data System (BI-RADS). Univariate and multivariate logistic regression models were used for the statistical analysis.
Results: In the univariate logistic regression, older age, higher body mass index, older age at menarche, and history of lactation were associated with more-fatty breasts. On the contrary, premenopausal status and use of hormone replacement therapy were associated with dense breasts. In the multivariate logistic regression, age and body mass index were inversely associated with breast density. Compared with the postmenopausal women, the premenopausal women had a 2.66-fold increase in breast density (odds ratio, 2.66; 95% confidence interval, 1.93–3.67).
Conclusion: Young age, lower body mass index, and premenopausal status were significantly associated with dense breasts in the Korean women in this study who were older than 40 years. Therefore, women with dense breasts who have the aforementioned risk factors need to be managed by individualized strategies with consideration of their age, breast obesity, and so on.
Keywords: Breast; Mammography; Mammographic Density; Women
References
  1. Jung KW, Won YJ, Kong HJ, Oh CM, Cho H, Lee DH, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015; 47: 127-41.
    Pubmed KoreaMed CrossRef
  2. Bae JM. On the benefits and harms of mammography for breast cancer screening in Korean women. Korean J Fam Pract 2014; 4: 1-6.
  3. Lee EH, Park B, Kim NS, Seo HJ, Ko KL, Min JW, et al. The Korean guideline for breast cancer screening. J Korean Med Assoc 2015; 58: 408-19.
    CrossRef
  4. Wolfe JN. Risk for breast cancer development determined by mammographic parenchymal pattern. Cancer 1976; 37: 2486-92.
    CrossRef
  5. Bertrand KA, Tamimi RM, Scott CG, Jensen MR, Pankratz V, Visscher D, et al. Mammographic density and risk of breast cancer by age and tumor characteristics. Breast Cancer Res 2013; 15: R104.
    Pubmed KoreaMed CrossRef
  6. Boyd NF, Martin LJ, Yaffe MJ, Minkin S. Mammographic density and breast cancer risk: current understanding and future prospects. Breast Cancer Res 2011; 13: 223.
    Pubmed KoreaMed CrossRef
  7. Park IH, Ko K, Joo J, Park B, Jung SY, Lee S, et al. High volumetric breast density predicts risk for breast cancer in postmenopausal, but not premenopausal, Korean women. Ann Surg Oncol 2014; 21: 4124-32.
    Pubmed CrossRef
  8. World Health Organization, International Obesity Task Force. The AsianPacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia; 2000.
  9. American College of Radiology. BI-RADS Committee. Illustrated breast imaging reporting and data system: Illustrated BI-RADS(tm). 3rd ed. Reston (VA): American College of Radiology; 1998.
  10. Boyd NF, Lockwood GA, Byng JW, Tritchler DL, Yaffe MJ. Mammographic densities and breast cancer risk. Cancer Epidemiol Biomarkers Prev 1998; 7:1133-44.
    CrossRef
  11. Grove JS, Goodman MJ, Gilbert FI Jr, Mi MP. Factors associated with mammographic pattern. Br J Radiol 1985; 58: 21-5.
    Pubmed CrossRef
  12. Grove JS, Goodman MJ, Gilbert F, Clyde D. Factors associated with breast structure in breast cancer patients. Cancer 1979; 43: 1895-9.
    CrossRef
  13. Brisson J, Morrison AS, Kopans DB, Sadowsky NL, Kalisher L, Twaddle JA, et al. Height and weight, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 1984; 119: 371-81.
    Pubmed CrossRef
  14. Stomper PC, D’Souza DJ, DiNitto PA, Arredondo MA. Analysis of parenchymal density on mammograms in 1353 women 25-79 years old. AJR Am J Roentgenol 1996; 167: 1261-5.
    Pubmed CrossRef
  15. Wolfe JN. Breast parenchymal patterns and their changes with age. Radiology 1976; 121: 545-52.
    Pubmed CrossRef
  16. Heng D, Gao F, Jong R, Fishell E, Yaffe M, Martin L, et al. Risk factors for breast cancer associated with mammographic features in Singaporean Chinese women. Cancer Epidemiol Biomarkers Prev 2004; 13: 1751-8.
    Pubmed
  17. Maskarinec G, Meng L, Ursin G. Ethnic differences in mammographic densities. Int J Epidemiol 2001; 30: 959-65.
    Pubmed CrossRef
  18. El-Bastawissi AY, White E, Mandelson MT, Taplin SH. Reproductive and hormonal factors associated with mammographic breast density by age (United States). Cancer Causes Control 2000; 11: 955-63.
    Pubmed CrossRef
  19. Titus-Ernstoff L, Tosteson AN, Kasales C, Weiss J, Goodrich M, Hatch EE, et al. Breast cancer risk factors in relation to breast density (United States). Cancer Causes Control 2006; 17: 1281-90.
    Pubmed KoreaMed CrossRef
  20. Duffy SW, Jakes RW, Ng FC, Gao F. Interaction of dense breast patterns with other breast cancer risk factors in a case-control study. Br J Cancer 2004; 91:233-6.
    CrossRef
  21. Cho JJ, Song HJ, Koh EY, Song YM, Han BK, Yun YS, et al. Mammographic breast density and risk factors of breast cancer in Korean women using multicenter study. J Korean Acad Fam Med 2006; 27: 33-41.
  22. Bradbury A, Olopade OI. The case for individualized screening recommendations for breast cancer. J Clin Oncol 2006; 24: 3328-30.
    Pubmed CrossRef


This Article

e-submission

Archives