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Longitudinal Changes in Volumetric Breast Density in Healthy Women across the Menopausal Transition
- Engmann, Natalie J;
- Scott, Christopher;
- Jensen, Matthew R;
- Winham, Stacey J;
- Ma, Lin;
- Brandt, Kathleen R;
- Mahmoudzadeh, Amir;
- Whaley, Dana H;
- Hruska, Carrie B;
- Wu, Fang-Fang;
- Norman, Aaron D;
- Hiatt, Robert A;
- Heine, John;
- Shepherd, John;
- Pankratz, V Shane;
- Miglioretti, Diana L;
- Kerlikowske, Karla;
- Vachon, Celine M
- et al.
Published Web Location
https://doi.org/10.1158/1055-9965.epi-18-1375Abstract
Background
Mammographic breast density declines during menopause. We assessed changes in volumetric breast density across the menopausal transition and factors that influence these changes.Methods
Women without a history of breast cancer, who had full field digital mammograms during both pre- and postmenopausal periods, at least 2 years apart, were sampled from four facilities within the San Francisco Mammography Registry from 2007 to 2013. Dense breast volume (DV) was assessed using Volpara on mammograms across the time period. Annualized change in DV from pre- to postmenopause was estimated using linear mixed models adjusted for covariates and per-woman random effects. Multiplicative interactions were evaluated between premenopausal risk factors and time to determine whether these covariates modified the annualized changes.Results
Among the 2,586 eligible women, 1,802 had one premenopausal and one postmenopausal mammogram, 628 had an additional perimenopausal mammogram, and 156 had two perimenopausal mammograms. Women experienced an annualized decrease in DV [-2.2 cm3 (95% confidence interval, -2.7 to -1.7)] over the menopausal transition. Declines were greater among women with a premenopausal DV above the median (54 cm3) versus below (DV, -3.5 cm3 vs. -1.0 cm3; P < 0.0001). Other breast cancer risk factors, including race, body mass index, family history, alcohol, and postmenopausal hormone therapy, had no effect on change in DV over the menopausal transition.Conclusions
High premenopausal DV was a strong predictor of greater reductions in DV across the menopausal transition.Impact
We found that few factors other than premenopausal density influence changes in DV across the menopausal transition, limiting targeted prevention efforts.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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