ASPO Abstracts
Reproductive, anthropometric and lifestyle factors in relation to Mammographic Breast Density in Hispanic Caribbean Women
Category: Cancer Health Disparities, Early Detection & Risk Prediction
Conference Year: 2018
Abstract Body:
Mammographic breast density (MBD), has been linked to many risk factors for breast cancer (BC) in mostly European and U.S. white populations, but remains understudied in many countries and non-white racial/ethnic groups including Hispanic Caribbean women. We investigated the associations of BC risk factors with MBD in 328 Hispanic women who were born or had parents born in a Caribbean country (age range: 40-64, 81% born in the Dominican Republic). We interviewed women with no history of BC at the time of screening data on BC risk factors, measured women’s height and weight, and assessed MBD from digital mammograms using Cumulus software in absolute (dense area, cm2) and relative (percent density) scales. In multivariable linear regression models, height (β=0.3, 95% CI 0.1, 0.5), lower parity (1-2 vs 3 births β=3.9, 95% CI 1.1, 6.8) and benign breast disease (β=2.9, 95% CI 2.7, 14.0) were associated with higher percent density (PD). In contrast, age at mammogram (β=-0.3, 95% CI -0.6, 0.0), postmenopausal status (β=-5.6, 95% CI -9.8, -1.3), and hormonal birth control use after first birth (β=-4.3, 95% CI -8.0, -0.7) were associated with lower PD. These associations, as well as a positive association for family history of BC, were also observed for dense area (β=16.5, 95% CI 6.3, 26.6). Increasing BMI was associated with lower PD (β=-0.6, 95% CI -0.8, -0.3), but was associated with larger dense area even after adjusting for nondense breast area (β=1.2, 95% CI 0.5, 1.9). Overall, we found similar associations for most BC risk factors for both relative and absolute measures of MBD that are consistent with prior research on MBD and with research on the associations of these risk factors with BC risk. However, the associations for BMI and reproductive factors related to parity, and hormonal birth control use are inconsistent with prior research. The results may suggest that familial, early life and endogenous hormonal factors, but not lifestyle, reproductive and exogenous hormonal factors, influence BC risk via MBD in Hispanic Caribbean women. Additional research in populations with different risk factor profiles can shed light on elucidating common and unique processes underlying MBD distribution and inform primary prevention strategies.
Keywords: Breast cancer; Mammographic breast density; Risk factors; Hispanic