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Int J Cancer. 2019 Feb 14. doi: 10.1002/ijc.32210. [Epub ahead of print]

Change in mammographic density across birth cohorts of Dutch breast cancer screening participants.

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Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Nykøbing Falster Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Computer Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Radiology, University Hospital Copenhagen, Copenhagen, Denmark.
Department of Epidemiology, Julius Center for Health, Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Radiology and Nuclear Medicine, Radboud University, Medical Center, Nijmegen, The Netherlands.


High mammographic density is a well-known risk factor for breast cancer. This study aimed to search for a possible birth cohort effect on mammographic density, which might contribute to explain the increasing breast cancer incidence. We separately analyzed left and right breast density of Dutch women from a 13-year period (2003-2016) in the breast cancer screening programme. First, we analyzed age-specific changes in average percent dense volume (PDV) across birth cohorts. A linear regression analysis (PDV vs. year of birth) indicated a small but statistically significant increase in women of: 1) age 50 and born from 1952 to 1966 (left, slope = 0.04, p = 0.003; right, slope = 0.09, p < 0.0001); 2) age 55 and born from 1948 to 1961 (right, slope = 0.04, p = 0.01); and 3) age 70 and born from 1933 to 1946 (right, slope = 0.05, p = 0.002). A decrease of total breast volume seemed to explain the increase in PDV. Second, we compared proportion of women with dense breast in women born in 1946-1953 and 1959-1966, and observed a statistical significant increase of proportion of highly dense breast in later born women, in the 51 to 55 age-groups for the left breast (around a 20% increase in each age-group), and in the 50 to 56 age-groups for the right breast (increase ranging from 27% to 48%). The study indicated a slight increase in mammography density across birth cohorts, most pronounced for women in their early 50s, and more marked for the right than for the left breast.


breast cancer screening; mammographic density; secular trends; volumetric breast density


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