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Involution of Breast Lobules, Mammographic Breast Density and Prognosis Among Tamoxifen-Treated Estrogen Receptor-Positive Breast Cancer Patients

  1. Author:
    Mullooly, Maeve
    Nyante, Sarah J
    Pfeiffer, Ruth M [ORCID]
    Cora, Renata [ORCID]
    Butcher,Donna
    Sternberg,Larry
    Aiello Bowles, Erin J
    Fan, Shaoqi [ORCID]
    Figueroa, Jonine D
    Weinmann, Sheila
    Hoover, Robert N
    Brinton, Louise A
    Berrington de Gonzalez, Amy
    Glass, Andrew
    Sherman, Mark E
    Gierach, Gretchen L

  2. Author Address

    Division of Population Health Sciences, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland. maevemullooly@rcsi.ie., Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. maevemullooly@rcsi.ie., Department of Radiology and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. sarah_nyante@med.unc.edu., Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. pfeiffer@mail.nih.gov., Independent Contractor, CT(ASCP), MB(ASCP), Stamford, CT 06901, USA. renata.cora@nih.gov., Pathology-Histotechnology Laboratory, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, MD 21702, USA. butcherdo@mail.nih.gov., Pathology-Histotechnology Laboratory, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, MD 21702, USA. sternberglr@mail.nih.gov., Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA. Erin.A.Bowles@kp.org., Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. shaoqi.fan@nih.gov., Usher Institute of Population Health Sciences and Informatics, CRUK Edinburgh Centre, Medical School, The University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK. jonine.figueroa@ed.ac.uk., Kaiser Permanente Northwest Center for Health Research, Portland, OR 97227, USA. Sheila.Weinmann@kpchr.org., Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. hooverr@exchange.nih.gov., Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. brintonl@exchange.nih.gov., Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. berringtona@mail.nih.gov., Kaiser Permanente Northwest Center for Health Research, Portland, OR 97227, USA. andy_5241@msn.com., Mayo Clinic, Jacksonville, FL 32224, USA. Sherman.Mark@mayo.edu., Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. gierachg@mail.nih.gov.,
    1. Year: 2019
    2. Date: Nov 04
    3. Epub Date: 2019 11 04
  2. Journal: Journal of clinical medicine
    1. 8
    2. 11
    3. Pages: pii: E1868.
  4. Type of Article: Article
  5. Article Number: 1868
  6. ISSN: 2077-0383
  1. Abstract:

    Mammographic breast density (MD) reflects breast fibroglandular content. Its decline following adjuvant tamoxifen treated, estrogen receptor (ER)-positive breast cancer has been associated with improved outcomes. Breast cancers arise from structures termed lobules, and lower MD is associated with increased age-related lobule involution. We assessed whether pre-treatment involution influenced associations between MD decline and risk of breast cancer-specific death. ER-positive tamoxifen treated patients diagnosed at Kaiser Permanente Northwest (1990-2008) were defined as cases who died of breast cancer (n = 54) and matched controls (remained alive over similar follow-up; n = 180). Lobule involution was assessed by examining terminal duct lobular units (TDLUs) in benign tissues surrounding cancers as TDLU count/mm2, median span and acini count/TDLU. MD (%) was measured in the unaffected breast at baseline (median 6-months before) and follow-up (median 12-months after tamoxifen initiation). TDLU measures and baseline MD were positively associated among controls (p < 0.05). In multivariable regression models, MD decline (=10%) was associated with reduced risk of breast cancer-specific death before (odds ratio (OR): 0.41, 95% CI: 0.18-0.92) and after (OR: 0.41, 95% CI: 0.18-0.94) adjustment for TDLU count/mm2, TDLU span (OR: 0.34, 95% CI: 0.14-0.84), and acini count/TDLU (OR: 0.33, 95% CI: 0.13-0.81). MD decline following adjuvant tamoxifen is associated with reduced risk of breast cancer-specific death, irrespective of pre-treatment lobule involution.

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External Sources

  1. View Full Text
  2. DOI: 10.3390/jcm8111868
  3. PMID: 31689948
  4. View record in Web of Science®
  5. WOS: 000502294400111
  6. PII : jcm8111868

Library Notes

  1. Fiscal Year: FY2019-2020
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