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Publication Detail
Localized fibroglandular tissue as a predictor of future tumor location within the breast.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Journal Article
  • Authors:
    Pinto Pereira SM, McCormack VA, Hipwell JH, Record C, Wilkinson LS, Moss SM, Hawkes DJ, dos-Santos-Silva I
  • Publication date:
    08/2011
  • Pagination:
    1718, 1725
  • Journal:
    Cancer Epidemiol Biomarkers Prev
  • Volume:
    20
  • Issue:
    8
  • Status:
    Published
  • Country:
    United States
  • PII:
    1055-9965.EPI-11-0423
  • Language:
    eng
  • Keywords:
    Adult, Breast, Breast Neoplasms, Female, Humans, Mammography, Middle Aged, Precancerous Conditions
Abstract
BACKGROUND: Mammographic density (MD) is a strong marker of breast cancer risk, but it is unclear whether tumors arise specifically within dense tissue. METHODS: In 231 British women diagnosed with breast cancer after at least one negative annual screening during a mammographic screening trial, we assessed whether tumor location was related to localized MD 5 years prior to diagnosis. Radiologists identified tumor locations on digitised films. We used a validated algorithm to align serial images from the same woman to locate the corresponding point on the prediagnostic film. A virtual 1 cm square grid was overlaid on prediagnostic films and MD calculated for each square within a woman's breast (mean = 271 squares/film). Conditional logistic regression, matching on a woman's breast, was used to estimate the odds of a tumor arising in a square in relation to its prediagnostic square-specific MD. RESULTS: Median (interquartile range) prediagnostic MD was 98.2% (46.8%-100%) in 1 cm-squares that subsequently contained the tumor and 41.0% (31.5%-53.9%) for the whole breast. The odds of a tumor arising in a 1 cm-square were, respectively, 6.1 (95% CI: 1.9-20.1), 16.6 (5.2-53.2), and 25.5-fold (8.1-80.3) higher for squares in the second, third, and fourth quartiles of prediagnostic MD relative to those in the lowest quartile within that breast (P(trend) < 0.001). The corresponding odds ratios were 2.3 (1.3-4.0), 3.9 (2.3-6.4), and 4.6 (2.8-7.6) if a 3 cm-square grid was used. CONCLUSION: Tumors arise predominantly within the radiodense breast tissue. IMPACT: Localized MD may be used as a predictor of subsequent tumor location within the breast.
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