Mammographic density and hormone receptor expression in breast cancer: the Multiethnic Cohort Study.
BACKGROUND
It is unclear whether mammographic breast density, a strong risk factor for breast cancer, predicts subtypes of breast cancer defined by estrogen receptor (ER) and/or progesterone receptor (PR) expression.


METHODS
In a nested case-control study, we compared the breast density of 667 controls and 607 breast cancer cases among women of Caucasian, Japanese, and Native Hawaiian ancestry in the Hawaii component of the Multiethnic Cohort Study. A reader blinded to disease status performed computer assisted density assessment on prediagnostic mammograms. Receptor status was obtained from the statewide Hawaii Tumor Registry. Tumors were classified into ER+PR+ (n=341), ER-PR- (n=50), ER+PR-/ER-PR+ (n=64), and unstaged/unknown (n=152). Mean percent density values were computed for women with more than one mammogram. Polytomous logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) while adjusting for confounders.


RESULTS
Mean percent density was significantly greater for ER+PR+ but not for ER-PR- tumors compared to controls after adjusting for age: 37.3%, 28.9% versus 29.4%, respectively. The overall OR per 10% increase in percent density were similar for ER+PR+ and ER+PR-/ER-PR+ tumors: 1.26 (95% CI 1.17-1.36) and 1.23 (95% CI 1.07-1.42), respectively. However, percent density was not found to be a predictor for ER-PR- tumors (OR 1.00, 95% CI 0.84-1.18). The results did not differ by ethnicity, nor by menopausal status, parity, or HRT use.


CONCLUSIONS
Our findings indicate that within a multiethnic population, women with higher breast density have an increased risk for ER+PR+ but not ER-PR- tumors.
Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA. sconroy@crch.hawaii.edu
Shannon M
SM
Conroy
Ian
I
Pagano
Laurence N
LN
Kolonel
Gertraud
G
Maskarinec
D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006254:Hawaii; D006801:Humans; D008297:Male; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012307:Risk Factors; D015996:Survival Rate
D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
Breast J. 2010 May-Jun;16(3):279-89
20408823
Cancer Epidemiol Biomarkers Prev. 2005 Nov;14(11 Pt 1):2641-7
16284390
Breast Cancer Res. 2008;10(1):201
18226174
Adv Exp Med Biol. 2008;630:94-111
18637487
Br J Cancer. 2004 Jan 26;90(2):393-6
14735182
Br J Cancer. 2009 Oct 20;101(8):1338-44
19773756
Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):662-8
15767347
Radiology. 2006 Sep;240(3):656-65
16857974
Cancer Epidemiol Biomarkers Prev. 2002 Sep;11(9):795-800
12223421
Am J Epidemiol. 2000 Feb 15;151(4):346-57
10695593
J Natl Cancer Inst. 1995 Nov 1;87(21):1622-9
7563205
N Engl J Med. 2006 Jan 19;354(3):270-82
16421368
Breast Cancer Res. 2007;9(1):R6
17239243
Cancer Epidemiol Biomarkers Prev. 2004 Dec;13(12):2090-5
15598766
Oncologist. 1998;3(4):237-252
10388110
Breast Cancer Res. 2006;8(3):R30
16796758
Breast Dis. 1998 Aug;10(3-4):113-26
15687568
Cancer Epidemiol Biomarkers Prev. 2005 Nov;14(11 Pt 1):2655-60
16284392
Am J Epidemiol. 2005 Oct 15;162(8):743-52
16150892
Cancer Epidemiol Biomarkers Prev. 2003 Apr;12(4):332-8
12692108
Br J Cancer. 2002 Oct 7;87(8):876-82
12373602
J Natl Cancer Inst. 2004 Feb 4;96(3):218-28
14759989
J Natl Cancer Inst. 2000 Jul 5;92(13):1081-7
10880551
Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1159-69
16775176
Phys Med Biol. 1994 Oct;39(10):1629-38
15551535
Cancer Epidemiol Biomarkers Prev. 2008 Apr;17(4):872-9
18398028
Pathol Oncol Res. 2008 Jun;14(2):161-7
18347932
Cancer Causes Control. 2000 Aug;11(7):653-62
10977110
Cancer Epidemiol Biomarkers Prev. 2005 May;14(5):1108-12
15894660
Cancer Epidemiol Biomarkers Prev. 2009 Feb;18(2):479-85
19190139