Mammographic density and prognosis in primary breast
cancer patients
by Felix Heindl, Peter A. Fasching, Alexander Hein, Carolin
C. Hack, Katharina Heusinger, Paul Gass, Patrik Pöschke, Frederik A. Stübs,
Rüdiger Schulz-Wendtland, Arndt Hartmann, Ramona Erber, Matthias W. Beckmann,
Julia Meyer, Lothar Häberle, Sebastian M. Jud, Julius Emons
The Breast: Published:
June 16, 2021
Purpose
Mammographic density (MD) is one of the strongest risk
factors for breast cancer (BC). However, the influence of MD on the BC
prognosis is unclear. The objective of this study was therefore to investigate
whether percentage MD (PMD) is associated with a difference in disease-free or
overall survival in primary BC patients.
Methods
A total of 2525 patients with primary, metastasis-free BC
were followed up retrospectively for this analysis. For all patients, PMD was
evaluated by two readers using a semi-automated method. The association between
PMD and prognosis was evaluated using Cox regression models with disease-free
survival (DFS) and overall survival (OS) as the outcome, and the following
adjustments: age at diagnosis, year of diagnosis, body mass index, tumor stage,
grading, lymph node status, hormone receptor and HER2 status.
Results
After median observation periods of 9.5 and 10.0 years, no
influence of PMD on DFS (p = 0.46, likelihood ratio test (LRT)) or OS (p = 0.22,
LRT), respectively, was found. In the initial unadjusted analysis higher PMD
was associated with longer DFS and OS. The effect of PMD on DFS and OS
disappeared after adjustment for age and was caused by the underlying age
effect.
Conclusions
Although MD is one of the strongest independent risk factors
for BC, in our collective PMD is not associated with disease-free and overall
survival in patients with BC.
