Raised mammographic density: causative mechanisms and biological consequences

Authorship

Raised mammographic density: causative mechanisms and biological consequences by Michael J. Sherratt, James C. McConnell and Charles H. Streuli

2016

Affiliations of authors

Faculties of Life and Medical and Human Sciences, University of Manchester, Oxford Road, Manchester

Key outtakes

  • “High mammographic density is the most important risk factor for breast cancer, after ageing.”
  • “Epidemiologically, the risk of developing breast cancer is significantly greater in those women with raised MD (‘mammographic density’).”
  • “MD is therapeutically modifiable, patient tolerance to long-term endocrine treatments (‘Tamoxifen’) is low…”
  • “MD is highly variable between women, ranging from a minimum of 3 % by volume, to very high levels of 25 % (Volpara measurements; the latter high level is equivalent to 75 % density in VAS).”
  • “The current understanding of the link between MD and breast cancer was reviewed extensively in 2014, with over 180 of the previous papers on this topic examined. Numerous studies, originating in 1976, have revealed that high MD is strongly linked with the susceptibility for breast cancer.”
  • “Indeed, women with high-dense breasts have a four-to sixfold greater risk of getting cancer than those with the lowest MD density.”
  • “More recently, it was found that the percentage of high MD is a stronger risk factor for breast cancer than absolute dense area.”
  • “Breast cancer is a major disease that affects 12 % of the female population at some point during their lifetime, and is the global cause of death for nearly 500,000 women per year.”
  • “Although there is a link between BMI and cancer, there is no direct association between BMI and MD.”
  • “Regardless of the role played by cellular hypertrophy, an altered stromal composition in women aged 50–69 years correlates with increased MD, although there is no difference in the amount of epithelial lobules or ducts.”
  • “It seems likely that raised MD is associated with a complex pattern of upregulation and downregulation of ECM proteins.”
  • “There are several therapeutic strategies to reduce or eliminate breast cancer from those who have it. The American Cancer Society sanctions six major kinds of treatment, including surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, and bone-directed therapy.”
  • “With high MD now being recognised as a major risk factor for cancer, the therapeutics that are used so far to reduce density and thereby to potentially protect against cancer arising from high MD mainly include selective ER modulators. For example, the anti-oestrogenic compounds tamoxifen, its relatives such as raloxifene and aromatase inhibitors, are prescribed to patients with high MD but yet have no signs of acquiring breast cancer.”
  • “Interestingly, breast cancer-specific survival occurred in tamoxifen-treated women who showed a reduction in MD.”
  • “…taking advantage of combined strategies to detect and/or revert high MD could reduce the incidence and mortality of breast cancer by more than 20 %.”

Paper

The full paper can be found here: Click here

 

 

Advertisements

International Consortium on Mammographic Density: Methodology and population diversity captured across 22 countries

Authorship

International Consortium on Mammographic Density: Methodology and population diversity captured across 22 countries

Valerie A. McCormacka-a, Anya Burtona-a, Isabel dos-Santos-Silva-b, John H. Hipwell-c, Caroline Dickens-d, Dorria Salem-e, Rasha Kamal-f, Mikael Hartman-g, Charmaine Pei Ling Lee-g-h, Kee-Seng Chia-h, Vahit Ozmen-i, Mustafa Erkin Aribal-i, Anath Arzee Flugelman-j, Martín Lajous-k-l, Ruy Lopez-Riduara-l, Megan Rice-m, Isabelle Romieu-n, Giske Ursin-o-p-q, Samera Qureshi-r, Huiyan Ma-s, Eunjung Lee-q, Carla H. van Gils-t, Johanna O.P. Wanders-t, Sudhir Vinayak-u, Rose Ndumia-u, Steve Allen-v, Sarah Vinnicombe-w, Sue Moss-x, Jong Won Lee-y, Jisun Kim-y, Ana Pereira-z, Maria Luisa Garmendia-z, Reza Sirous-A, Mehri Sirous-A, Beata Peplonska-B, Agnieszka Bukowska-B, Rulla M. Tamimi-m, Kimberly Bertrand-C, Chisato Nagata-D, Ava Kwong-E, Celine Vachon-F, Christopher Scott-F, Beatriz Perez-Gomez-G, Marina Pollan-G, Gertraud Maskarinec-H, Graham Giles-I-J, John Hopper-J, Jennifer Stone-K, Nadia Rajaram-L, Soo-Hwang Teo-L-M, Shivaani Mariapun-L, Martin J. Yaffe-N, Joachim Schüz-a, Anna M. Chiarelli-O, Linda Linton-P, Norman F. Boyd-P

  • a) Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
  • b) Dept of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  • c) Centre for Medical Image Computing, University College London, UK
  • d) University of the Witwatersrand, South Africa
  • e) Cairo University, Egypt
  • f) Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt
  • g) Department of Surgery, Yong Loo Lin School of Medicine and Saw Swee Hock School of Public Health, National University of Singapore, Singapore
  • h) NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
  • i) Istanbul University, Turkey
  • j) National Cancer Control Center, Israel
  • k) Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
  • l) Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico, Mexico City, Mexico
  • m) Channing Division of Network Medicine, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, USA
  • n) Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France o Cancer Registry of Norway, Oslo, Norway
  • p) Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
  • q) Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
  • r) Norwegian Center for Minority Health Research (NAKMI), Oslo, Norway
  • s) Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, USA
  • t) Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
  • u) Aga Khan University Hospital, Nairobi, Kenya
  • v) Department of Imaging, Royal Marsden NHS Foundation Trust, London, UK
  • w) Division of Cancer Research, Ninewells Hospital & Medical School, Dundee, UK
  • x) Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
  • y) Asan Medical Center, Seoul, Republic of Korea
  • z) Institute of Nutrition and Food Technology, University of Chile, Chile
  • A) Isfahan University of Medical Sciences, Isfahan, Iran
  • B) Nofer Institute of Occupational Medicine, Łód z, Poland
  • C) Slone Epidemiology Center, Boston University, Boston, MA, USA
  • D) Gifu University, Gifu, Japan
    E) Division of Breast Surgery, The University of Hong Kong Faculty of Medicine, and Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong, Peoples Republic of China
  • F) Dept Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
  • G) Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain
  • H) University of Hawaii Cancer Center, Honolulu, Hawaii, USA
  • I) Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
  • J) School of Population and Global Health, The University of Melbourne, Australia
  • K) Centre for Genetic Origins of Health and Disease, University of Western Australia, Australia
  • L) Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
  • M) Cancer Research Malaysia, Subang Jaya, Malaysia
  • N) Medical Biophysics, University of Toronto, Canada
  • O) Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Canada
  • P) Princess Margaret Cancer Centre, Toronto, Canada

2015

Study scope/scale

The International Consortium of Mammographic Density (ICMD) is co-ordinated by the International Agency for Research on Cancer (IARC). In ICMD, we pooled individual-level MD and epidemiologic data from studies of breast cancer-free women worldwide. ICMD includes 11755 women from 27 studies across 22 countries.

Key outtakes

  • “Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk.”
  • “Since Wolfe’s first studies linking mammographic parenchymal patterns to breast cancer (BC) risk in 1976, breast density – typically measured on a mammogram as mammographic density (MD) – is now recognized as one of the strongest risk factors for this malignancy.”
  • “Several observations suggest that MD is on a causal pathway for BC, including that tumours arise within localised areas of dense tissue, MD and BC have a partially shared genetic basis, the effects of several BC risk factors have concordant effects on MD, and some may be mediated through MD.”
  • “The International Consortium of Mammographic Density (ICMD) is co-ordinated by the International Agency for Research on Cancer (IARC).”

Paper

The full paper can be found here: Click here