Multiple metabolic risk factors and mammographic breast density.
OBJECTIVE
We examined whether obesity and a history of diabetes, hypertension, and elevated cholesterol, individually and in combination, are associated with breast density, a strong risk factor for breast cancer.


METHODS
We measured percent density and dense area using a computer-assisted method (n = 191; age range = 40-61 years). We used linear regression models to examine the associations of each metabolic condition and the number of metabolic conditions (zero, one, two, and three or four conditions) with breast density.


RESULTS
Among individual metabolic conditions, only high blood cholesterol was inversely associated with percent density (β = -5.4, 95% confidence interval [CI]: -8.5, -2.2) and dense area (β = -6.7, 95% CI = -11.1, -2.4). Having multiple metabolic conditions was also associated with lower breast density, with two conditions and three or four conditions versus zero conditions associated with 6.4% (95% CI: -11.2, -1.6) and 7.4% (95% CI: -12.9, -1.9) reduction in percent density and with 6.5 cm(2) (95% CI: -13.1, -0.1) and 9.5 cm(2) (95% CI: -17.1, -1.9) decrease in dense area.


CONCLUSIONS
A history of high blood cholesterol and multiple metabolic conditions were associated with lower relative and absolute measures of breast density. The positive association between metabolic abnormalities and breast cancer risk may be driven by pathways unrelated to mammographic breast density.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY. Electronic address: pt140@columbia.edu.
Parisa
P
Tehranifar
School of Nursing, Long Island University, Brooklyn Campus, Brooklyn, NY.
Diane
D
Reynolds
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
Xiaozhou
X
Fan
Division of Social Epidemiology, Department of Health Evidence and Policy, Department of Neurology, ICAHN School of Medicine at Mount Sinai, New York, NY.
Bernadette
B
Boden-Albala
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
Natalie J
NJ
Engmann
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
Julie D
JD
Flom
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Mary Beth
MB
Terry
D000328:Adult; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000378:metabolism; D015897:Comorbidity; D005260:Female; D006801:Humans; D016014:Linear Models; D042361:Mammary Glands, Human / Q000002:abnormalities* / Q000378:metabolism; D008327:Mammography / Q000379:methods; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors
Cholesterol; Diabetes; Hypertension; Mammographic breast density; Obesity