Longitudinal Changes in Breast Density may predict subsequent Breast Cancer Risk: JAMA

USA: A new study published in JAMA: Oncology has found that evaluating longitudinal change in breast density from digital mammograms could be a predictor for assessing subsequent breast cancer risk.

Breast cancer is one of the most common forms of cancer among women worldwide, and early detection is key to successful treatment. While breast density has been established as a risk factor for breast cancer, further research is needed about the longitudinal changes in breast density over time and whether these changes are associated with an increased risk of developing breast cancer.

The study conducted at Joanne Knight Breast Health Cohort, St Louis used a nested case-control cohort design that observed over 10,481 women from 2008 to 2020 and identified 289 cases of breast cancer.

Breast density was measured via routine screening mammograms every 1-2 years, and changes in volumetric breast density over time were assessed. Additionally, breast cancer risk factors were collected through questionnaires at enrollment, and breast biopsy pathology confirmed cancer diagnoses.

The study revealed the following clinical takeaways:

1. The mean interval between the last mammogram and subsequent breast cancer diagnosis was 2.0 years.

2. Breast density decreased over time in both cases and controls.

3. The rate of decline in breast density was significantly slower in the breast that developed cancer compared to controls.

4. The estimate for the slower decline was 0.027, the rate of breast density decrease was slower in the breast that developed cancer compared to controls.

Mammography is the most commonly used screening tool for breast cancer, but its accuracy can be affected by factors such as breast density. The findings of this study could lead to more effective screening and prevention strategies for women at higher risk of developing breast cancer.

However, more research is needed to confirm the findings of this study and to determine how best to incorporate longitudinal changes in breast density into existing risk models.

Reference:

Jiang S, Bennett DL, Rosner BA, Colditz GA. Longitudinal Analysis of Change in Mammographic Density in Each Breast and Its Association With Breast Cancer Risk. JAMA Oncol. Published online April 27, 2023. doi:10.1001/jamaoncol.2023.0434