title: Deterministic models for breast cancer progression: application to the association between mammographic parenchymal pattern and histologic grade of breast cancers.
abstract: Dense mammographic patterns are a risk factor for breast cancer. In a recent case-control study, dense patterns were observed to be associated with a higher relative risk estimate for the more aggressive grade 3 tumors than for grade 1 or 2 tumors. The present study was designed to ascertain, by reference to odds ratio estimates of relative risk by tumor size and histologic grade, whether this was more likely to be due to increased innate predisposition of dense parenchymal patterns to grade 3 tumors, or to dedifferentiation of cases missed at screening due to dense patterns. If the observation were due entirely to dedifferentiation, then for a given size the relative risk of grade 3 tumors would be the same as for grades 1-2. Size-specific relative risks of grade 3 tumors were higher than those of grade 1-2 tumors. It is concluded that the majority of the enhanced risk of grade 3 tumors is due to enhanced innate predisposition to grade 3 tumors in dense breasts.
authors.affiliation: MRC Biostatistics Unit, Institute of Public Health, Robinson Way, Cambridge CB2 2SR, UK. d.a.harrison.95@cantab.net
authors.forename: D A
authors.initials: DA
authors.lastname: Harrison
authors.forename: S W
authors.initials: SW
authors.lastname: Duffy
authors.forename: E
authors.initials: E
authors.lastname: Sala
authors.forename: R M L
authors.initials: RM
authors.lastname: Warren
authors.forename: E
authors.initials: E
authors.lastname: Couto
authors.forename: N E
authors.initials: NE
authors.lastname: Day
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology*; D002454:Cell Differentiation; D015331:Cohort Studies; D018450:Disease Progression; D004198:Disease Susceptibility; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D008954:Models, Biological; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors