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To address the effect if mammographic density (MD) in breast cancer outcomes, we investigated the association of MD with IBTR and contralateral breast cancer in a large cohort of patients treated at a single institution The cumulative incidence of IBTR in this patient cohort was 2.1% at 10 years. As shown in Figure, the high MD group had a higher incidence of IBTR with a HR of 1.44 (95% CI, 1.07-1.95). Age at the time of operation was shown to be a significant risk factor for IBTR (HR, 0.95; 95% CI, 0.94-0.97; P < .001), and younger age was also associated with the likelihood of having high MD (HR, 1.05; 95% CI, 1.05-1.06; P < .001). To adjust for the association of age with IBTR, we stratified the patients according to their age at operation. When the patients were stratified by their median age, MD was not associated with the development of IBTR. Cox proportional hazards regression analysis also revealed that the degree of MD was not an independent risk factor for IBTR development.For contralateral breast cancer, the cumulative rate at 5 years was 1.4%. Similar to the IBTR, high MD and young age were risk factors for developing contralateral breast cancer. However, the risk of contralateral breast cancer among patients with high MD was increased in those who were younger than 50 years of age. Furthermore, unlike IBTR, the degree of MD remained an independent risk factor for contralateral breast cancer after adjusting for other risk factors.
Cheun JH, Kim HK, Lee HB, Han W, Moon HG.
JAMA Surg. 2021 Nov 24. doi: 10.1001/jamasurg.2021.5859
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