Association Between Radio-pathological Breast Tumor Characteristics and Mammographic Breast Density
Abstract
Background: Despite mammographic density being a strong indicator of breast cancer risk, it is unclear whether there is association between breast density and certain breast cancer subtypes. This study aimed to investigate the relation between radiologic breast density category and tumor characteristics.
Methods: Patients with histologically proven breast cancer who had undergone diagnostic mammography were reviewed retrospectively from 2016 to 2019. The American College of Radiology BI-RADS mammographic density categories were recorded and grouped into low (a and b), and high (c and d). Patient characteristics as well as tumor size, border, pathology, ER, PR, Her2 immunohistochemistry was extracted from the mammography, ultrasonography, and core needle pathology reports. Binary logistic regression model was used to analyze the association between breast density and receptors, molecular subtypes, or tumor features.
Results: The present study was comprised of 129 patients, with 7, 47, 41, and 34 patients in the density categories a, b, c, and d, respectively. Patients who had a higher breast density were significantly younger (p=0.001). Those with a lower density were more likely to have HER2, IHC 0 tumors (Odds ratio adjusted for age = 4.9, 95% CI 1.25-18.27, p=0.022). Mammographic density was not related to molecular subtypes and other tumor features.
Conclusion: Mammographic dense breast may be associated with Her2 positive breast cancer.
Full text article
References
Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2024;74(3):229-63. DOI: 10.3322/caac.21834
Ramadan SZ. Methods Used in Computer‐Aided Diagnosis for Breast Cancer Detection Using Mammograms: A Review. Journal of healthcare engineering. 20;2020(1):9162464. DOI 10.1155/2020/9162464
Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012;367(21):1998–2005. DOI: 10.1056/NEJMoa1206809
Wang AT, Vachon CM, Brandt KR, Ghosh K. Breast density and breast cancer risk: a practical review. In: Mayo Clinic Proceedings. Elsevier; 2014. p. 548–57. DOI: 10.1016/j.mayocp.2013.12.014
Ali EA, Raafat M. Relationship of mammographic densities to breast cancer risk. Egypt J Radiol Nucl Med. 2021;52:1–5. DOI: 10.21608/ejrnm.2021.13788
McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2006;15(6):1159–69. DOI: 10.1158/1055-9965.epi-06-0034
Huo CW, Chew GL, Britt KL, Ingman W V, Henderson MA, Hopper JL, et al. Mammographic density—a review on the current understanding of its association with breast cancer. Breast Cancer Res Treat. 2014;144:479–502. DOI: 10.1007/s10549-014-2901-2
von Euler-Chelpin M, Lillholm M, Vejborg I, Nielsen M, Lynge E. Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark. Breast Cancer Res. 2019;21:1–7. DOI: 10.1186/s13058-019-1203-3
Yaghjyan L, Esnakula AK, Scott CG, Wijayabahu AT, Jensen MR, Vachon CM. Associations of mammographic breast density with breast stem cell marker-defined breast cancer subtypes. Cancer Causes Control. 2019;30:1103–11. DOI: 10.1007/s10552-019-01207-w
Pizzato M, Carioli G, Rosso S, Zanetti R, La Vecchia C. Mammographic breast density and characteristics of invasive breast cancer. Cancer Epidemiol. 2021;70:101879. DOI: 10.1016/j.canep.2020.101879
Yaghjyan L, Colditz GA, Collins LC, Schnitt SJ, Rosner B, Vachon C, et al. Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to tumor characteristics. J Natl Cancer Inst. 2011;103(15):1179–89. DOI: 10.1093/jnci/djr225
Won HS, Ahn J, Kim Y, Kim JS, Song JY, Kim HK, Lee J, Park HK, Kim YS. Clinical significance of HER2-low expression in early breast cancer: a nationwide study from the Korean Breast Cancer Society. Breast Cancer Research. 2022 Mar 21;24(1):22. DOI: 10.1186/s13058-022-01519-x
Gokhale S. Ultrasound characterization of breast masses. Indian J Radiol Imaging. 2009 Jul;19(03):242-7. DOI: 10.4103/0971-3026.54878
Cullinane C, Brien AO, Shrestha A, Hanlon EO, Walshe J, Geraghty J, et al. The association between breast density and breast cancer pathological response to neoadjuvant chemotherapy. Breast Cancer Res Treat. 2022;194(2):385–92. DOI: 10.1007/s10549-022-06616-1
Conroy SM, Pagano I, Kolonel LN, Maskarinec G. Mammographic density and hormone receptor expression in breast cancer: the Multiethnic Cohort Study. Cancer Epidemiol. 2011;35(5):448–52. DOI: 10.1016/j.canep.2010.11.011
Shaikh AJ, Mullooly M, Sayed S, Ndumia R, Abayo I, Orwa J, et al. Mammographic breast density and breast cancer molecular subtypes: the Kenyan-African aspect. Biomed Res Int. 2018;2018. DOI: 10.1155/2018/6026315
Sajjad B, Farooqi N, Rehman B, Khalid IB, Urooj N, Sajjad S, et al. Correlation of Breast Density Grade on Mammogram With Diagnosed Breast Cancer: A Retrospective Cross-Sectional Study. Cureus. 2022;14(7). DOI: 10.7759/cureus.27028
Arora N, King TA, Jacks LM, Stempel MM, Patil S, Morris E, et al. Impact of breast density on the presenting features of malignancy. Ann Surg Oncol. 2010;17:211–8. DOI: 10.1245/s10434-010-1237-3
Phipps AI, Buist DSM, Malone KE, Barlow WE, Porter PL, Kerlikowske K, et al. Breast density, body mass index, and risk of tumor marker-defined subtypes of breast cancer. Ann Epidemiol. 2012;22(5):340–8. DOI: 10.1016/j.annepidem.2012.02.002
Fasching PA, Heusinger K, Loehberg CR, Wenkel E, Lux MP, Schrauder M, Koscheck T, Bautz W, Schulz-Wendtland R, Beckmann MW, Bani MR. Influence of mammographic density on the diagnostic accuracy of tumor size assessment and association with breast cancer tumor characteristics. European journal of radiology. 2006 Dec 1;60(3):398-404. DOI: 10.1016/j.ejrad.2006.08.002
Ma H, Luo J, Press MF, Wang Y, Bernstein L, Ursin G. Is there a difference in the association between percent mammographic density and subtypes of breast cancer? Luminal A and triple-negative breast cancer. Cancer Epidemiol biomarkers Prev. 2009;18(2):479–85. DOI: 10.1158/1055-9965.epi-08-0805
McCarthy AM, Friebel‐Klingner T, Ehsan S, He W, Welch M, Chen J, et al. Relationship of established risk factors with breast cancer subtypes. Cancer Med. 2021;10(18):6456–67. DOI: 10.1002/cam4.4158
Balema WA, Moseley TW, Weaver O, Hess KR, Brewster AM. The association between volumetric breast density and breast cancer subtypes among women newly diagnosed with breast cancer. American Society of Clinical Oncology; 2019: e13115-e13115. DOI: 10.1200/jco.2019.37.15_suppl.e13115
Antoni S, Sasco AJ, dos Santos Silva I, McCormack V. Is mammographic density differentially associated with breast cancer according to receptor status? A meta-analysis. Breast Cancer Res Treat. 2013;137:337–47.
Tan V, Payne J, Paquet N, Iles S, Rayson D, Barnes P, et al. The association between breast density and HER2-positive breast cancer: A population-based case-control study. American Society of Clinical Oncology; 2020: e12556-e12556. DOI: 10.1200/jco.2020.38.15_suppl.e12556
Li E, Guida JL, Tian Y, Sung H, Koka H, Li M, et al. Associations between mammographic density and tumor characteristics in Chinese women with breast cancer. Breast Cancer Res Treat. 2019;177:527–36. DOI: 10.1007/s10549-019-05325-6
Bai S, Song D, Chen M, Lai X, Xu J, Dong F. The association between mammographic density and breast cancer molecular subtypes: A systematic review and meta-analysis. Clin Radiol. 2023;78(8):622-32 DOI: doi.org/10.1016/j.crad.2023.04.008
Ma JH, Qin L, Li X. Role of STAT3 signaling pathway in breast cancer. Cell Communication and Signaling. 2020 Dec;18:1-3.DOI: 10.1186/s12964-020-0527-z
Radenkovic S, Konjevic G, Gavrilovic D, Stojanovic-Rundic S, Plesinac-Karapandzic V, Stevanovic P, et al. pSTAT3 expression associated with survival and mammographic density of breast cancer patients. Pathol Pract. 2019;215(2):366–72. DOI: 10.1016/j.prp.2018.12.023
Marchiò C, Annaratone L, Marques A, Casorzo L, Berrino E, Sapino A. Evolving concepts in HER2 evaluation in breast cancer: Heterogeneity, HER2-low carcinomas and beyond. InSeminars in cancer biology 2021 Jul 1 (Vol. 72, pp. 123-135). Academic Press. DOI: 10.1016/j.semcancer.2020.02.016
Sartor H, Borgquist S, Hartman L, Zackrisson S. Do pathological parameters differ with regard to breast density and mode of detection in breast cancer? The Malmö Diet and Cancer Study. The Breast. 2015;24(1):12–7. DOI: 10.1016/j.breast.2014.10.006
Pollán M, Ascunce N, Ederra M, Murillo A, Erdozáin N, Alés-Martínez JE, et al. Mammographic density and risk of breast cancer according to tumor characteristics and mode of detection: a Spanish population-based case-control study. Breast Cancer Res. 2013;15(1):1–11. DOI: 10.1186/bcr3380
Authors
Copyright (c) 2024 Archives of Breast Cancer
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright©. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International License, which permits copy and redistribution of the material in any medium or format or adapt, remix, transform, and build upon the material for any purpose, except for commercial purposes.