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Grand Rounds

The Impact of Dense Breast Tissue and Benign Breast Disease on Breast Cancer Risk

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BACKGROUND AND PURPOSE:

  • Women with dense breast tissue and benign breast disease have a higher risk of developing breast cancer
  • Most studies investigating this link have been performed in White women
  • Relationship has not been quantified in Asian women, who have higher breast tissue density than White women
  • Literature regarding the combination of dense breast tissue and benign breast disease is also limited
  • Kim et al. (Radiology, 2022) investigated the risk of breast cancer associated with mammographic density and benign breast disease among women in South Korea

METHODS:

  • Retrospective Cohort Study
    • Analysis of data from a nationwide breast cancer screening program in South Korea
  • Population
    • 40 to 74 years
    • Screened for breast cancer between January 2009 and December 2010
  • Exposures
    • Benign breast disease
    • Breast density based on Breast Imaging Reporting and Data System [BI-RADS]
  • Study design
    • 10 year follow up: Observed up to December 2020
    • Cox proportional hazard regression analysis was used to calculate adjusted hazard ratios (HRs)
  • Primary outcome
    • Breast cancer risk

RESULTS:

  • 3,911,348 women
    • Mean age: 53 years
    • Median follow up: 10.6 years
    • Breast cancer cases: 58,321
  • Of the women who developed breast cancer, 18.4% had cases of benign breast disease during screening
  • There was a greater risk of breast cancer for women with extremely dense breasts and benign breast disease (vs women with fatty breasts and without benign breast disease)
    • HR 2.75 (95% CI, 2.63 to 2.88); P<0.001
  • There was also an elevate breast cancer risk among
    • Women with benign breast disease and fatty breasts
      • HR 1.49 (95% CI, 1.40 to 1.58); P<0.001
    • Women without benign breast disease and extremely dense breasts
      • HR 2.28 (95% CI, 2.20 to 2.35); P<0.001

CONCLUSION:

  • South Korean women with extremely dense breast tissue and/or benign breast disease at screening had an elevated risk of developing breast cancer
  • The authors state

Furthermore, we confirmed the association between benign breast disease and breast cancer risk that has been shown in previous studies

Benign breast disease has been associated with increased breast cancer risk with a four-fold increased risk in women with atypia and a two-fold increased risk in women with proliferative lesions

Learn More – Primary Sources:

Mammographic Breast Density, Benign Breast Disease, and Subsequent Breast Cancer Risk in 3.9 Million Korean Women

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Related ObG Topics:

BI-RADS: Standardizing Breast Imaging and Reporting 
Office Evaluation of Breast Disorders
ACOG Reaffirms Breast Density Guidance – FDA Proposes New Notification Rule
Has Breast Density Legislation Had Any Impact on Breast Cancer Diagnosis? 
Which Mammography Recommendation Results in the Greatest Breast Cancer Mortality Reduction?

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