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J Natl Cancer Inst. 2019 Jul 12. pii: djz149. doi: 10.1093/jnci/djz149. [Epub ahead of print]

Mammographic Density Change and Risk of Breast Cancer.

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Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Radiology, Södersjukhuset, Stockholm, Sweden.
Department of Oncology, Södersjukhuset, Stockholm, Sweden.



We examined the association between annual mammographic density change (MDC) and breast cancer (BC) risk, and how annual MDC influences the association between baseline mammographic density (MD) and BC risk.


We used the KARMA cohort of Swedish women (N = 43,810) aged 30-79 years with full access to BC risk factors and mammograms. MD was measured as dense area (cm2) and percent MD using the STRATUS method. We used the contralateral mammogram for women with BC, and randomly selected a mammogram from either left or right breast for healthy women. We calculated relative area MDC between repeated examinations. Relative area MDC was categorized as decreased (>10% decrease/year), stable (no change) or increased (>10% increase/year). We used Cox proportional hazards regression to estimate the association of BC with MDC and interaction analysis to investigate how MDC modified the association between baseline MD and BC risk. All tests of statistical significance were two sided.


In all, 563 women were diagnosed with BC. Compared to women with a decreased MD over time, no statistically significant different in BC risk was seen for women with either stable MD or increasing MD (HR = 1.01, 95% CI = 0.82 to 1.23, P = 0.90 and HR = 0.98, 95%CI= 0.80 to 1.22, P = 0.90 respectively). Categorizing baseline MD and subsequently adding MDC did not seem to influence the association between baseline MD and BC risk.


Our results suggest that annual MDC does not influence BC risk. Furthermore, MDC does not seem to influence the association between baseline MD and BC risk.


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