Analysis of the Factors, Effective on Breast Parenchymal Density in Mammogram

Document Type : Original Article

Authors

Abstract

Introduction: Breast parenchymal density is one of the factors that can cause false negative mammographic results. This work was performed to determine the frequency and distribution of dense mammograms.
 
Materials and Methods: The peresent descriptive study was carried out from April 2003 to March 2004 on women referring to Radiology Department, Ghaem Hospital, Mashhad. A total of 1000 women with fatty (≤50% density) or dense breasts (≥ 90% density) who had screening or diagnostic mammography were studied. Breast density, breast size and presence of benign calcifications were analyzed. Clinical data such as age, parity, age at first conception, use of hormone replacement therapy (H.R.T), and family history of breast cancer were recorded and analyzed by the frequency distribution tables and descriptive statistic, Ki square and spirman test.
 
Results: Parenchymal density on mammograms was found to correlate with the age, and decrease progressively from 25–29 years old through 75–79 years old (Spearman correlation P = 0.001). Increased parenchymal density was more common in women who had smaller breast, and had fewer than two pregnancies, or underwent H.R.T (P < 0.001). The prevalence of benign calcifications also increased with age.
 
Conclusion: This study confirmed the effectiveness of age and HRT on mammographic density, suggesting a possible reduction of mammographic sensitivity and efficacy for detecting malignancy in these groups of patients.

Keywords

References

1. Bird RE, Wallace TW, Yankaskas Bc. Analysis of cancers missed at screening mammography
Radiology 1992 ; 184 (3) : 613 – 7.
2. Holland R, Hendriks JH, Mravunacm M.Mammographically occult breast cancer. A pathologic
and radiologic study. Cancer 1983 ; 52 (10) : 1810 – 9.
 
3. Van Gils C, Otten y, Verbeek A, Hendriks JH, Holland R. Effect of mammographic breast
density of breast cancer screening performance, a study in Nijmegen , the Netherlands. J
Epidemiol community Health 1998 ; 52 : 267–71.
4. Reintgen D,Berman C , Cox C , Baekey P, Nicosia S, Greenberg H, et al. The anatomy of
missed breast cancers. Surg oncol 1993 ; 2 : 65 – 75.
5. Patel M, Whitman G.Negative mammograms in symptomatic patients with breast cancer. Acad
Radiol 1998 ; 5 : 26 – 33.
6. Kerlikowske K, Grady D, Braclay J, Sickles EA, Ernster V. Effect of age, breast density and
family history on the sensitivity of first screening mammography. JAMA 1996; 276: 33 – 38.
7. Jackson VP , Hendrick RE, Feig SA, Kopans DB. Imaging of the radiographically dense breast.
Radiol 1993 ; 188 (2) : 297 – 301.
8. Hams SE, Flaming DP, Hesley KL, Meiches MD, Jensen RA, Evans WP, et al. MR Imaging of
the breast with rotating delivery of excitation off resonance : clinical expeience with pathologic
correlation. Radiol 1993 ; 187 (2) : 493 – 501.
9. Powell KA, Obuchowski NA, Darvos Wy , Chilcote WA. Quantitative analysis of breast
parenchymal density : correlation with women's age. Acad Radiol 1999; 6 (12): 742 – 7.
10. EL – Bastawissi AY , White E, Mandelson MT. Taplin S. Variation in mammographic breast
density by race. Ann Epidemiol 2001; 11(4): 257 – 263.
11. Brisson J, Morrison As, Khalid N.Mammographic Parenchymal Features and breast cancer in the
breast cancer detection demonstration project. J Natl Cancer Inst 1988; 80 (19): 1534 – 40.
12. Haiman CA, Bernstein L, Van Den Berg D, Ingles SA, Salane M, Ursin G. Genetic determinants
of mammographic density. Breast cancer Res 2002; 4 (R5).
13. Wolf JN. Breast parenchymal patterns and their changes with age. Radiol 1976; 121 (3): 545 – 52.
14. Stomper P, D 'Souza D,Dinitto P, Arredondo MA. Analysis of parenchymal density on
mammograms in 1353 women 25 – 79 years old. Am J Radiol 1996; 167: 1261–1265.
15. Sickles EA. Mammographic features of 300 consecutive non palpable breast cancers AJR, 1986;
146 (4): 661–3.
16. Page DL, Winfield AC. The dense mammogram (editorial). AJR 1986; 147: 487 – 9.
17. Stomper PC, Penetrante RB, Edge SB , Arredondo MA, Blumenson LE, Stewart CC. Cellular
proliferative activity of mammographic normal dense and fatty tissue determined by DNA S
phase percentage. Breast cancer Res treat 1996; 37: 229 – 39.
18. Warren R.Hormones and mammograhic breast density. Maturitas 2004; 49: 67 – 78.
19. Marchesoni D,Driul L, Ianni A, Fabiani G, Della Martina M, Zuiani C, et al. Postmenopausal
hormone therapy and mammographic breast density. Maturitas 2006; 53: 59 – 64.
20. Ziv E, shepherd J, Smith – Bindman R, Kerlikowske K. Mammographic breast density and
family history of breast cance. J Natl Cancer Inst 2003; 95 (7): 556 – 8.
21. Boyd NF, Byng JW, JONG RA, Fishell EK, Little LE, Miller AB, et al. Quantitative
Classification of mammographic densities and breast cancer risk: result from the Canadian
National breast screening study. J Natl Cancer Inst 1995; 87 (9): 670 – 5.
22. Nango Y, Kawaguchi Y, Sugiyama y, Saji S, Kashiki Y. Relationship between mammographic
density and the risk of breast cancer in Japanese women: a case – control study. Breast cancer
2003; 10 (3): 228 – 33.
23. Greendale GA, Reboussin BA, Slone S , Wasilauskas C, Pike MC, Ursin G. Postmenopausal
hormone therapy and change in mammographic density. J Natl cancer Inst 2003; 95(1): 30 –37.
24. Baines CJ. Menstrual cycle variation in mammographic breast density: so who cares? J Natl
cancer Inst 1998; 90 (12): 875 – 6.
25. White E, Velentgas P, Mendelson M, Lehman CD, Elmore JG, Porter P, et al.Variation in
mammographic breast density by time in menstrual cycle among women aged 40 – 49 years.J
Natl cancear Inst 1998 ; 90 (12) : 906 – 910.
26. Boren W, Hunter T, Bjelland J, Hunter KR. Comparison of breast consistency at palpation with
breast density at mammography. Invest Radiol 1990; 25: 1010 – 11.
27. Rosenberg R, Hunt W, Williamson M, Gilliland FD, Wiest PW, Kelsey CA, et al. Effect of age,
breast density, ethnicity, and estrogen replacement therapy on screening mammographic
sensitivity and cancer stage at diagnosis: Review of 183134 screening mammograms in
Albuquerque, New Mexico. Radiol 1998; 209: 511 – 518.
28. Laya MB, Gallagher JC, Schreiman JS, Larson EB, Watson P, Weinstein L. Effect of
postmenopausal hormonal replacement therapy on mammographic density and parenchymal
pattern. Radiol 1995; 196 (2): 433–7.
29. Ciatto S, Bonardi R, Zappa M. Impact of replacement hormone therapy in menopause on breast
radiologic density and possible complications of mammography in the assessment of breast
masses. Radiol Med 2001; 101 (1-2): 39 – 43.
30. Kaewrudee S,Anuwutnavin S, Kanpittaya J, Soontrapa S, Sakondhavata C. Effect of estrogen –
progestin and estrogen on mammographic density. J Reprod Med, 2007; 52(6) : 513 -20.

Files

Share

How to cite

Statistics