title: Association of mammographic density with hormone receptors in invasive breast cancers: results from a case-only study.
abstract: For many breast cancer (BC) risk factors, there is growing evidence concerning molecular subtypes for which the risk factor is specific. With regard to mammographic density (MD), there are inconsistent data concerning its association with estrogen receptor (ER) and progesterone receptor (PR) expression. The aim of our study was to analyze the association between ER and PR expression and MD. In our case-only study, data on BC risk factors, hormone receptor expression and MD were available for 2,410 patients with incident BC. MD was assessed as percent MD (PMD) using a semiautomated method by two readers for every patient. The association of ER/PR and PMD was studied with multifactorial analyses of covariance with PMD as the target variable and including well-known factors that are also associated with MD, such as age, parity, use of hormone replacement therapy, and body mass index (BMI). In addition to the commonly known associations between PMD and age, parity, BMI and hormone replacement therapy, a significant inverse association was found between PMD and ER expression levels. Patients with ER-negative tumors had an average PMD of 38%, whereas patients with high ER expression had a PMD of 35%. A statistical trend toward a positive association between PMD and PR expression was also seen. PMD appears to be inversely associated with ER expression and may correlate positively with PR expression. These effects were independent of other risk factors such as age, BMI, parity, and hormone replacement therapy, possibly suggesting other pathways that mediate this effect.
authors.affiliation: Department of Gynecology and Obstetrics, University Breast Center for Franconia, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Heusinger
authors.forename: Sebastian M
authors.initials: SM
authors.lastname: Jud
authors.forename: Lothar
authors.initials: L
authors.lastname: Häberle
authors.forename: Carolin C
authors.initials: CC
authors.lastname: Hack
authors.forename: Boris R
authors.initials: BR
authors.lastname: Adamietz
authors.forename: Martina
authors.initials: M
authors.lastname: Meier-Meitinger
authors.forename: Michael P
authors.initials: MP
authors.lastname: Lux
authors.forename: Thomas
authors.initials: T
authors.lastname: Wittenberg
authors.forename: Florian
authors.initials: F
authors.lastname: Wagner
authors.forename: Christian R
authors.initials: CR
authors.lastname: Loehberg
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.forename: Arndt
authors.initials: A
authors.lastname: Hartmann
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Peter A
authors.initials: PA
authors.lastname: Fasching
mesh_terms: D000368:Aged; D015992:Body Mass Index; D000071060:Breast Density; D001943:Breast Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D042361:Mammary Glands, Human / Q000002:abnormalities / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D010298:Parity; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D011980:Receptors, Progesterone / Q000096:biosynthesis*; D012307:Risk Factors
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone