Longitudinal Changes in Volumetric Breast Density with Tamoxifen and Aromatase Inhibitors.
Background:Reductions in breast density with tamoxifen and aromatase inhibitors may be an intermediate marker of treatment response. We compare changes in volumetric breast density among breast cancer cases using tamoxifen or aromatase inhibitors (AI) to untreated women without breast cancer.Methods:Breast cancer cases with a digital mammogram prior to diagnosis and after initiation of tamoxifen (n= 366) or AI (n= 403) and a sample of controls (n= 2170) were identified from the Mayo Clinic Mammography Practice and San Francisco Mammography Registry. Volumetric percent density (VPD) and dense breast volume (DV) were measured using Volpara (Matakina Technology) and Quantra (Hologic) software. Linear regression estimated the effect of treatment on annualized changes in density.Results:Premenopausal women using tamoxifen experienced annualized declines in VPD of 1.17% to 1.70% compared with 0.30% to 0.56% for controls and declines in DV of 7.43 to 15.13 cm3compared with 0.28 to 0.63 cm3in controls, for Volpara and Quantra, respectively. The greatest reductions were observed among women with ≥10% baseline density. Postmenopausal AI users had greater declines in VPD than controls (VolparaP= 0.02; QuantraP= 0.03), and reductions were greatest among women with ≥10% baseline density. Declines in VPD among postmenopausal women using tamoxifen were only statistically greater than controls when measured with Quantra.Conclusions:Automated software can detect volumetric breast density changes among women on tamoxifen and AI.Impact:If declines in volumetric density predict breast cancer outcomes, these measures may be used as interim prognostic indicators.Cancer Epidemiol Biomarkers Prev; 26(6); 930-7. ©2017 AACR.
University of California, San Francisco, San Francisco, California. natalie.engmann@ucsf.edu.
Natalie J
NJ
Engmann
Mayo Clinic, Rochester, Minnesota.
Christopher G
CG
Scott
Mayo Clinic, Rochester, Minnesota.
Matthew R
MR
Jensen
University of California, San Francisco, San Francisco, California.
Lin
L
Ma
Mayo Clinic, Rochester, Minnesota.
Kathleen R
KR
Brandt
University of California, San Francisco, San Francisco, California.
Amir Pasha
AP
Mahmoudzadeh
University of California, San Francisco, San Francisco, California.
Serghei
S
Malkov
Mayo Clinic, Rochester, Minnesota.
Dana H
DH
Whaley
Mayo Clinic, Rochester, Minnesota.
Carrie B
CB
Hruska
Mayo Clinic, Rochester, Minnesota.
Fang Fang
FF
Wu
Mayo Clinic, Rochester, Minnesota.
Stacey J
SJ
Winham
University of California, Davis, Davis, California.|Group Health Research Institute, Seattle, Washington.
Diana L
DL
Miglioretti
Mayo Clinic, Rochester, Minnesota.
Aaron D
AD
Norman
Moffitt Cancer Center, Tampa, Florida.
John J
JJ
Heine
University of California, San Francisco, San Francisco, California.
John
J
Shepherd
University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
V Shane
VS
Pankratz
Mayo Clinic, Rochester, Minnesota.
Celine M
CM
Vachon
University of California, San Francisco, San Francisco, California.
Karla
K
Kerlikowske
D000328:Adult; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D000071060:Breast Density / Q000187:drug effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013629:Tamoxifen / Q000009:adverse effects*
D047072:Aromatase Inhibitors; D013629:Tamoxifen