Reproductive and Hormonal Factors Associated with Fatty or Dense Breast Patterns among Korean Women
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초록
Purpose Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women. Materials and Methods Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis. Results In univariate logistic regression, older age, higher body mass index, older age at menarche,and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend ＜0.01, respectively),whereas nulliparous and premenopausal status were positively associated. Compared to women who had ≥2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend ＜0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32). Conclusion Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.
Abstract
Purpose Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women. Materials and Methods Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis. Results In univariate logistic regression, older age, higher body mass index, older age at menarche,and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend ＜0.01, respectively),whereas nulliparous and premenopausal status were positively associated. Compared to women who had ≥2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend ＜0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32). Conclusion Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.
참고문헌 (25)
- Boyd NF, "Mammographic density and the risk and detection of breast cancer", N Engl J Med, 356, pp.227~236 (2007)
- McCormack VA, "Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis", Cancer Epidemiol Biomarkers Prev, 15, pp.1159~1169 (2006)
- Nagata C, "Mammographic density and the risk of breast cancer in Japanese women", Br J Cancer, 92, pp.2102~2106 (2005)
- Ursin G, "Mammographic density and breast cancer in three ethnic groups", Cancer Epidemiol Biomarkers Prev, 12, pp.332~338 (2003)
- Maskarinec G, "Ethnic and geographic differences in mammographic density and their association with breast cancer incidence", Breast Cancer Res Treat, 104, pp.47~56 (2007)
- Heng D, "Risk factors for breast cancer associated with mammographic features in Singaporean chinese women", Cancer Epidemiol Biomarkers Prev, 13, pp.1751~1758 (2004)
- El-Bastawissi AY, "Reproductive and hormonal factors associated with mammographic breast density by age (United States)", Cancer Causes Control, 11, pp.955~963 (2000)
- Butler LM, "Menstrual and reproductive factors in relation to mammographic density: the Study of Women's Health Across the Nation (SWAN)", Breast Cancer Res Treat, 112, pp.165~174 (2008)
- Bray F, "The changing global patterns of female breast cancer incidence and mortality", Breast Cancer Res, 6, pp.229~239 (2004)
- 원영주, "Nationwide Cancer Incidence in Korea, 2003~2005", Cancer Research and Treatment, 41(3), pp.122~131 (2009), 대한암학회
- Chia KS, "Profound changes in breast cancer incidence may reflect changes into a Westernized lifestyle: a comparative population-based study in Singapore and Sweden", Int J Cancer, 113, pp.302~306 (2005)
- Boyd NF, "Mammographic breast density as an intermediate phenotype for breast cancer", Lancet Oncol, 6, pp.798~808 (2005)
- Maskarinec G, "Ethnic differences in mammographic densities", Int J Epidemiol, 30, pp.959~965 (2001)
- 강은영, "한국여성에서 방사선학적 치밀 유방과 유방암 위험 요인과의 연관성", Korean Journal of Family Medicine, 28(12), pp.937~942 (2007), 대한가정의학회
- Titus-Ernstoff L, "Breast cancer risk factors in relation to breast density (United States)", Cancer Causes Control, 17, pp.1281~1290 (2006)
- Gram IT, "Percentage density, Wolfe’s and Tabár’s mammographic patterns: agreement and association with risk factors for breast cancer", Breast Cancer Res, 7, pp.R854~R861 (2005)
- McCormack VA, "Ethnic variations in mammographic density: a British multiethnic longitudinal study", Am J Epidemiol, 168, pp.412~421 (2008)
- Jeffreys M, "Life course breast cancer risk factors and adult breast density (United Kingdom)", Cancer Causes Control, 15, pp.947~955 (2004)
- Ursin G, "Greatly increased occurrence of breast cancers in areas of mammographically dense tissue", Breast Cancer Res, 7, pp.R605~R608 (2005)
- Stuedal A, "Does breast size modify the association between mammographic density and breast cancer risk", Cancer Epidemiol Biomarkers Prev, 17, pp.621~627 (2008)
- Pike MC, "Estrogens, progestogens, normal breast cell proliferation, and breast cancer risk", Epidemiol Rev, 15, pp.17~35 (1993)
- Boyd NF, "Heritability of mammographic density, a risk factor for breast cancer", N Engl J Med, 347, pp.886~894 (2002)
- Kim SH, "Analysis and comparison of breast density according to age on mammogram between Korean and Western women", J Korean Radiol Soc, 42, pp.1009~1014 (2000)
- 조정진, "다기관 연구를 통해 살펴본 한국여성에서 유방밀도와 유방암 위험요인", Korean Journal of Family Medicine, 27(1), pp.33~41 (2006), 대한가정의학회
- Tseng M, "Acculturation and breast density in foreign-born, U.S. Chinese women", Cancer Epidemiol Biomarkers Prev, 15, pp.1301~1305 (2006)