High Mammographic Breast Density Is Independent Predictor of Local But Not Distant Recurrence After Lumpectomy and Radiotherapy for Invasive Breast Cancer

Rembert, James; Chew, Karen; Moore, Dan; Kerlikowske, Karla

doi:10.1016/j.ijrobp.2008.04.007

Title: High Mammographic Breast Density Is Independent Predictor of Local But Not Distant Recurrence After Lumpectomy and Radiotherapy for Invasive Breast Cancer

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Abstract

Purpose: Biologically meaningful predictors for locoregional recurrence (LRR) in patients undergoing breast-conserving surgery (BCS) and radiotherapy (RT) are lacking. Tissue components, including extracellular matrix, could confer resistance to ionizing radiation. Fibroglandular and extracellular matrix components of breast tissue relative to adipose tissue can be quantified by the mammographic breast density (MBD), the proportion of dense area relative to the total breast area on mammography. We hypothesized that the MBD might be a predictor of LRR after BCS and RT for invasive breast cancer. Methods and Materials: We conducted a nested case-control study of 136 women with invasive breast cancer who had undergone BCS and RT and had had the MBD ascertained before, or at, diagnosis. Women with known recurrence were matched to women without recurrence by year of diagnosis. The median follow-up was 7.7 years. The percentage of MBD was measured using a computer-based threshold method. Results: Patients with a high MBD ({>=}75% density) vs. low ({<=}25%) were at increased risk of LRR (hazard ratio, 4.30; 95% confidence interval, 0.88-021.0; p = 0.071) but not distant recurrence. In addition, we found a complete inverse correlation between high MBD and obesity (body mass index, {>=}30 kg/m{sup 2}). In a multivariate Coxmore »« less

Authors:

Rembert, James ^[1]; Chew, Karen ^[2]; Moore, Dan ^[3]; Kerlikowske, Karla ^[3]

Department of Radiation Oncology, University of California, San Francisco, School of Medicine, San Francisco, CA (United States)
Department of Laboratory Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA (United States)
Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA (United States)

Publication Date:: Thu Jan 01 00:00:00 EST 2009

OSTI Identifier:: 21172536

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 73; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2008.04.007; PII: S0360-3016(08)00640-8; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; ADIPOSE TISSUE; BIOMEDICAL RADIOGRAPHY; CARCINOMAS; DIAGNOSIS; IONIZING RADIATIONS; MAMMARY GLANDS; METABOLIC DISEASES; RADIOTHERAPY; SURGERY

Citation Formats


                    Park, Catherine C., Rembert, James, Chew, Karen, Moore, Dan, Kerlikowske, Karla, and Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA. High Mammographic Breast Density Is Independent Predictor of Local But Not Distant Recurrence After Lumpectomy and Radiotherapy for Invasive Breast Cancer.  United States: N. p., 2009. 
        Web.  doi:10.1016/j.ijrobp.2008.04.007.

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                    Park, Catherine C., Rembert, James, Chew, Karen, Moore, Dan, Kerlikowske, Karla, & Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA. High Mammographic Breast Density Is Independent Predictor of Local But Not Distant Recurrence After Lumpectomy and Radiotherapy for Invasive Breast Cancer.  United States.  https://doi.org/10.1016/j.ijrobp.2008.04.007

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                    Park, Catherine C., Rembert, James, Chew, Karen, Moore, Dan, Kerlikowske, Karla, and Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA. 2009.  
        "High Mammographic Breast Density Is Independent Predictor of Local But Not Distant Recurrence After Lumpectomy and Radiotherapy for Invasive Breast Cancer".  United States.  https://doi.org/10.1016/j.ijrobp.2008.04.007.

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@article{osti_21172536,

  title        = {High Mammographic Breast Density Is Independent Predictor of Local But Not Distant Recurrence After Lumpectomy and Radiotherapy for Invasive Breast Cancer},

  author       = {Park, Catherine C. and Rembert, James and Chew, Karen and Moore, Dan and Kerlikowske, Karla and Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA},

  abstractNote = {Purpose: Biologically meaningful predictors for locoregional recurrence (LRR) in patients undergoing breast-conserving surgery (BCS) and radiotherapy (RT) are lacking. Tissue components, including extracellular matrix, could confer resistance to ionizing radiation. Fibroglandular and extracellular matrix components of breast tissue relative to adipose tissue can be quantified by the mammographic breast density (MBD), the proportion of dense area relative to the total breast area on mammography. We hypothesized that the MBD might be a predictor of LRR after BCS and RT for invasive breast cancer. Methods and Materials: We conducted a nested case-control study of 136 women with invasive breast cancer who had undergone BCS and RT and had had the MBD ascertained before, or at, diagnosis. Women with known recurrence were matched to women without recurrence by year of diagnosis. The median follow-up was 7.7 years. The percentage of MBD was measured using a computer-based threshold method. Results: Patients with a high MBD ({>=}75% density) vs. low ({<=}25%) were at increased risk of LRR (hazard ratio, 4.30; 95% confidence interval, 0.88-021.0; p = 0.071) but not distant recurrence. In addition, we found a complete inverse correlation between high MBD and obesity (body mass index, {>=}30 kg/m{sup 2}). In a multivariate Cox proportional hazards model, patients with MBD in the greatest quartile were at significantly greater risk of LRR (hazard ratio, 6.6; 95% confidence interval, 1.6-27.7; p = 0.01). Obesity without a high MBD also independently predicted for LRR (hazard ratio, 19.3; 95% confidence interval, 4.5-81.7; p < 0.001). Conclusion: The results of our study have shown that a high MBD and obesity are significant independent predictors of LRR after BCS and RT for invasive breast cancer. Additional studies are warranted to validate these findings.},

  doi          = {10.1016/j.ijrobp.2008.04.007},

  url          = {https://www.osti.gov/biblio/21172536},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 1,

  volume       = 73,

  place        = {United States},

  year         = {Thu Jan 01 00:00:00 EST 2009},

  month        = {Thu Jan 01 00:00:00 EST 2009}

}

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