The Association of Mammographic Breast Density and Breast Cancer Biology Among Breast Cancer Women in Jordan

Abstract

Background: A breast mammogram is considered the gold standard modality for breast cancer screening. The sensitivity of breast mammograms is highly linked to mammographic breast density (MBD) which is strongly linked to women's age, ethnicity, and other factors.  Higher breast density is considered one of the risk factors for breast cancer development and it can be associated with different pathological and biological features of breast cancer.

Methods: This is a retrospective review of 97 women with a diagnosis of breast cancer in a tertiary hospital in Jordan who were diagnosed in the period between 2018 and 2020. We compared patients with a positive status for estrogen (ER) or progesterone (PR) receptors (ER⁺/PR⁺) and others with negative receptors (ER^-/PR^-), in terms of their correlation with MBD.

Results: The analysis has included 97 patients. Of which, 87.6% had either a PR⁺ or an ER⁺, and 38.1% of patients were positive for HER2/neu protein. The sample mean age was 56.4 and most patients were obese (56.7%). MBD of our cohort was 30.9% (30/97) fatty, 29.9% (29/97) scattered, 23.7% (23/97) heterogeneously dense, and 15.5% (15/97) dense. The ER⁺/PR⁺ group was more associated with fatty (35.3% vs 0.0%) and scattered (31.8% vs 25.0%) MBD types than the ER^-/PR^- group, and less associated with the dense type (9.4% vs 58.3%), and the association was statistically significant (P < 0.001). However, no statistically significant correlation was found between MBD and the HER2/neu protein status.

Conclusion: According to our results, ER⁺/PR⁺ group patients tend to have fatty and scattered MBD types than the ER^-/PR^- patients. Larger randomized cohorts should investigate the association between breast cancer biological subtypes and MBD.