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J Clin Oncol. 2010 Aug 20;28(24):3830-7. doi: 10.1200/JCO.2009.26.4770. Epub 2010 Jul 19.

Breast cancer risk by breast density, menopause, and postmenopausal hormone therapy use.

Author information

  • 1General Internal Medicine Section, University of California, San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA. Karla.Kerlikowske@ucsf.edu

Abstract

PURPOSE:

We determined whether the association between breast density and breast cancer risk and cancer severity differs according to menopausal status and postmenopausal hormone therapy (HT) use.

METHODS:

We collected data on 587,369 women who underwent 1,349,027 screening mammography examinations; 14,090 women were diagnosed with breast cancer. We calculated 5-year breast cancer risk from a survival model for subgroups of women classified by their Breast Imaging Reporting and Data System (BIRADS) breast density, age, menopausal status, and current HT use, assuming a body mass index of 25 kg/m(2). Odds of advanced (ie, IIb, III, IV) versus early (ie, I, IIa) stage invasive cancer was calculated according to BIRADS density.

RESULTS:

Breast cancer risk was low among women with low density (BIRADS-1): women age 55 to 59 years, 5-year risk was 0.8% (95% CI, 0.6 to 0.9%) for non-HT users and 0.9% (95% CI, 0.7% to 1.1%) for estrogen and estrogen plus progestin users. Breast cancer risk was high among women with very high density (BIRADS-4), particularly estrogen plus progestin users: women age 55 to 59 years, 5-year risk was 2.4% (95% CI, 2.0% to 2.8%) for non-HT users, 3.0% (95% CI, 2.6% to 3.5%) for estrogen users, and 4.2% (95% CI, 3.7% to 4.6%) for estrogen plus progestin users. Advanced-stage breast cancer risk was increased 1.7-fold for postmenopausal HT users who had very high density (BIRADS-4) compared to those with average density (BIRADS-2).

CONCLUSION:

Postmenopausal women with high breast density are at increased risk of breast cancer and should be aware of the added risk of taking HT, especially estrogen plus progestin.

PMID:
20644098
[PubMed - indexed for MEDLINE]
PMCID:
PMC2940400
Free PMC Article
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