title: Mammographic density as a risk factor for breast cancer in a German case-control study.
abstract: Mammographic percent density (MD) is recognized as one of the strongest risk factors associated with breast cancer. This matched case-control study investigated whether MD represents an independent risk factor. Mammograms were obtained from 1025 breast cancer patients and from 520 healthy controls. MD was measured using a quantitative computer-based threshold method (0-100%). Breast cancer patients had a higher MD than healthy controls (38 vs. 32%, P<0.01). MD was significantly higher in association with factors such as age over 60 years, body mass index (BMI) of 25-30 kg/m², nulliparity or low parity (one to two births). Average MD was inversely associated with age, BMI, parity and positively associated with age at first full-term pregnancy. MD was higher in women with at least one first-degree relative affected, but only among patients and not in the group of healthy controls (P<0.01/P=0.61). In women with an MD of 25% or more, the risk of breast cancer was doubled compared with women with an MD of less than 10% (odds ratio: 2.1; 95% confidence interval: 1.3-3.4; P<0.01); in the postmenopausal subgroup, the risk was nearly tripled (odds ratio: 2.7; 95% confidence interval: 1.6-4.7; P<0.001). This study provides further evidence that MD is an important risk factor for breast cancer. These results indicate strong associations between MD and the risk of breast cancer in a matched case-control study in Germany.
authors.affiliation: University Breast Center Franconia, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Heusinger
authors.forename: Christian R
authors.initials: CR
authors.lastname: Loehberg
authors.forename: Lothar
authors.initials: L
authors.lastname: Haeberle
authors.forename: Sebastian M
authors.initials: SM
authors.lastname: Jud
authors.forename: Peter
authors.initials: P
authors.lastname: Klingsiek
authors.forename: Alexander
authors.initials: A
authors.lastname: Hein
authors.forename: Christian M
authors.initials: CM
authors.lastname: Bayer
authors.forename: Claudia
authors.initials: C
authors.lastname: Rauh
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.forename: Alexander
authors.initials: A
authors.lastname: Cavallaro
authors.forename: Matthias S
authors.initials: MS
authors.lastname: May
authors.forename: Boris
authors.initials: B
authors.lastname: Adamietz
authors.forename: Ruediger
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.forename: Thomas
authors.initials: T
authors.lastname: Wittenberg
authors.forename: Florian
authors.initials: F
authors.lastname: Wagner
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Peter A
authors.initials: PA
authors.lastname: Fasching
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D001940:Breast / Q000033:anatomy & histology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics; D016022:Case-Control Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D005858:Germany; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010298:Parity; D012307:Risk Factors