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Type 2 diabetes and mammographic breast density among underserved women

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Abstract

Purpose

We conducted a study of women recruited at Meharry Medical College, a historically black medical school, to investigate the relationship between diabetes and mammographic breast density.

Methods

A total of 476 women completed in-person interviews, body measurements, and full-field digital mammograms on a Hologic mammography unit from December 2011 to February 2014. Average percent breast density for the left and right breasts combined was estimated using Quantra, an automated algorithm for volumetric assessment of breast tissue. The prevalence of type 2 diabetes was determined by self-report.

Results

After adjustment for confounding variables, the mean percent breast density among premenopausal women with type 2 diabetes [\(\hat{\mu }\) 13.8 %, 95 % confidence interval (CI) 11.6–15.9] was nonsignificantly lower than that of women without type 2 diabetes (\(\hat{\mu }\) 15.9 %, 95 % CI 15.0–16.8) (p = 0.07); however, there was no association among postmenopausal women. The effect of type 2 diabetes in severely obese women (BMI ≥ 35) appeared to differ by menopausal status with a reduction in mean percent breast density in premenopausal women, but an increase in mean percent breast density in postmenopausal women which could have been due to chance.

Conclusions

Confirmation of our findings in larger studies may assist in clarifying the role of the insulin signaling breast cancer pathway in women with high breast density.

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References

  1. Wolf I, Sadetzki S, Catane R, Karasik A, Kaufman B (2005) Diabetes mellitus and breast cancer. Lancet Oncol 6:103–111

    Article  CAS  PubMed  Google Scholar 

  2. Larsson SC, Mantzoros CS, Wolk A (2007) Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer 121:856–862

    Article  CAS  PubMed  Google Scholar 

  3. Xue F, Michels KB (2007) Diabetes, metabolic syndrome, and breast cancer: a review of the current evidence. Am J Clin Nutr 86:s823–s835

    PubMed  Google Scholar 

  4. Liao S, Li J, Wei W, Wang L, Zhang Y, Li J, Wang C, Sun S (2011) Association between diabetes mellitus and breast cancer risk: a meta-analysis of the literature. Asian Pac J Cancer Prev 12:1061–1065

    PubMed  Google Scholar 

  5. Lambe M, Wigertz A, Garmo H, Walldius G, Jungner I, Hammar N (2011) Impaired glucose metabolism and diabetes and the risk of breast, endometrial, and ovarian cancer. Cancer Causes Control 22:1163–1171

    Article  PubMed  Google Scholar 

  6. Bowker SL, Marra CA, Richardson K, Johnson JA (2011) Risk of breast cancer after onset of type 2 diabetes. Diabetes Care 34:2542–2544

    Article  PubMed Central  PubMed  Google Scholar 

  7. Boyd NF, Lockwood GA, Byng JW, Tritchler DL, Yaffe MJ (1998) Mammographic densities and breast cancer risk. Cancer Epidemiol Biomarkers Prev 7:1133–1144

    CAS  PubMed  Google Scholar 

  8. McCormack VA, dos Santos SilvaI (2006) Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 15:1159–1169

    Article  PubMed  Google Scholar 

  9. Vachon CM, Kuni CC, Anderson K, Anderson VE, Sellers TA (2000) Association of mammographically defined percent breast density with epidemiologic risk factors for breast cancer (United States). Cancer Causes Control 11:653–662

    Article  CAS  PubMed  Google Scholar 

  10. Berube S, Diorio C, Masse B, Hebert-Croteau N, Byrne C, Cote G, Pollak M, Yaffe M, Brisson J (2005) Vitamin D and calcium intakes from food or supplements and mammographic breast density. Cancer Epidemiol Biomarkers Prev 14:1653–1659

    Article  CAS  PubMed  Google Scholar 

  11. El-Bastawissi AY, White E, Mandelson MT, Taplin S (2001) Variation in mammographic breast density by race. Ann Epidemiol 11:257–263

    Article  CAS  PubMed  Google Scholar 

  12. Chen Z, Wu AH, Gauderman WJ, Bernstein L, Ma H, Pike MC, Ursin G (2004) Does mammographic density reflect ethnic differences in breast cancer incidence rates? Am J Epidemiol 59:140–147

    Article  Google Scholar 

  13. Habel LA, Capra AM, Oestreicher N et al (2007) Mammographic density in a multiethnic cohort. Menopause 14:891–899

    Article  PubMed  Google Scholar 

  14. del Carmen MG, Halpern EF, Kopans DB, Moy B, Moore RH, Goss PE, Hughes KS (2007) Mammographic breast density and race. AJR Am J Roentgenol 188:1147–1150

    Article  PubMed  Google Scholar 

  15. Tehranifar P, Reynolds D, Flom J, Fulton L, Liao Y, Kudadjie-Gyamfi E, Terry MB (2011) Reproductive and menstrual factors and mammographic density in African American, Caribbean, and White women. Cancer Causes Control 22:599–610

    Article  PubMed  Google Scholar 

  16. del Carmen MG, Hughes KS, Halpern E, Rafferty E, Kopans D, Parisky YR, Sardi A, Esserman L, Rust S, Michaelson J (2003) Racial differences in mammographic breast density. Cancer 98:590–596

    Article  PubMed  Google Scholar 

  17. Boyd NF, Rommens JM, Vogt K, Lee V, Hopper JL, Yaffe MJ, Paterson AD (2005) Mammographic breast density as an intermediate phenotype for breast cancer. Lancet Oncol 6:798–808

    Article  PubMed  Google Scholar 

  18. Roubidoux MA, Kuar JS, Griffith KA, Sloan J, Wilson C, Novotny P, Lobell M (2003) Correlates of mammogram density in Southwestern Native-American women. Cancer Epidemiol Biomarkers Prev 12:552–558

    PubMed  Google Scholar 

  19. Furberg A-S, Jasienska G, Bjurstam N, Torjesen PA, Emaus A, Lipson SF, Ellison PT, Thune I (2005) Metabolic and hormonal profiles: hDL cholesterol as a plausible biomarker of breast cancer risk. The Norwegian EBBA Study. Cancer Epidemiol Biomarkers Prev 14:33–40

    CAS  PubMed  Google Scholar 

  20. Diorio C, Pollak M, Byrne C, Masse B, Hebert-Croteau N, Yaffe M, Cote G, Berube S, Morin C, Brisson J (2005) Insulin-like growth factor-I, IGF-binding protein-3, and mammographic breast density. Cancer Epidemiol Biomarkers Prev 14:1065–1073

    Article  CAS  PubMed  Google Scholar 

  21. Maskarinec G, Woolcott C, Steude JS, Franke AA, Cooney RV (2010) The relation of leptin and adiponectin with breast density among premenopausal women. Eur J Cancer Prev 19:55–60

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Sickles EA, D’Orsi CJ, Bassett LW et al (2013) ACR BI-RADS® mammography. In: ACR BI-RADS® atlas, breast imaging reporting and data system. American College of Radiology, Reston

  23. Michels KB, Solomon CG, Hu FB, Rosner BA, Hankinson SE, Colditz G, Manson JE (2003) Type 2 diabetes and subsequent incidence of breast cancer in the Nurses’ Health Study. Diabetes Care 26:1752–1758

    Article  PubMed  Google Scholar 

  24. Bal TA (2009) C-peptide: roles in diabetes, insulilnoma, and hypoglyecemia. Siemens perspectives. www.siemens.com/diagnostics

  25. Buse JB, Polonsky KS, Burant CF (2011) Type 2 diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM (eds) Williams textbook of endocrinology, 12th edn. Elsevier Saunders, Philadelphia, pp 1371–1435

    Chapter  Google Scholar 

  26. Dupont WD (2009) Statistical modeling for biomedical researchers: a simple introduction to the analysis of complex data, 2nd edn. Cambridge University Press, Cambridge, pp 97–155

    Google Scholar 

  27. Vachon CM, Pankratz VS, Scott CG et al (2007) Longitudinal trends in mammographic percent density and breast cancer risk. Cancer Epidemiol Biomarkers Prev 16:921–928

    Article  PubMed  Google Scholar 

  28. Centers for Disease Control and Prevention (2014) National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Department of Health and Human Services, Atlanta

    Google Scholar 

  29. Sellers TA, Jensen LE, Vierkant RA, Fredricksen ZS, Brandt KR, Giuliano AR, Pamkrantz VS, Cerhan JR, Vachon CM (2007) Association of diabetes with mammographic breast density and breast cancer in the Minnesota breast cancer family study. Cancer Causes Control 18:505–515

    Article  PubMed  Google Scholar 

  30. Byng JW, Boyd NF, Fishell E, Jong RA, Yaffe MJ (1994) The quantitative analysis of mammographic densities. Phys Med Biol 39:1629–1638

    Article  CAS  PubMed  Google Scholar 

  31. Diorio C, Pollak M, Byrne C, Masse B, Hebert-Croteau N, Yaffe M, Cote G, Berube S, Brisson J (2005) Levels of c-peptide and mammographic breast density. Cancer Epidemiol Biomarkers Prev 14:2661–2664

    Article  CAS  PubMed  Google Scholar 

  32. Ahern TP, Hankinson SE, Willett WC, Pollak MN, Eliassen AH, Tamimi RM (2013) Plasma c-peptide, mammographic breast density, and risk of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 22:1786–1796

    Article  CAS  PubMed  Google Scholar 

  33. Goodwin PJ, Thompson AM, Stambolic V (2012) Diabetes, metformin, and breast cancer: lilac time? J Clin Oncol 30:2812–2814

    Article  PubMed  Google Scholar 

  34. Chlewbowski RT, McTiernan A, Wactawski-Wende J et al (2012) Diabetes, metformin, and breast cancer in postmenopausal women. J Clin Oncol 30:2844–2852

    Article  Google Scholar 

  35. Bershtein LM, Vasil’ev DA, Kovalenko IG, Poroshina TE, Kisel’nikov KS, Boiarkina MP, Zaitsev AN (2012) The influence of metformin and N-acetylcysteine on mammographic density in postmenopausal women. Vopr Onkol 58:45–49

    CAS  PubMed  Google Scholar 

  36. Wang J, Azziz A, Fan B et al (2013) Agreement of mammographic measures of volumetric breast density to MRI. PLoS ONE 8:e81653

  37. Ciatto S, Bernardi D, Calabrese M et al (2012) A first evaluation of breast radiological density assessment by QUANTRA software as compared to visual classification. Breast 21:503–506

    Article  PubMed  Google Scholar 

  38. Engelken F, Singh JM, Fallenberg EM, Bick U, Bottcher J, Renz DM (2014) Volumetric breast composition analysis: reproducibility of breast percent density and fibroglandular tissue volume measurements in serial mammograms. Acta Radiol 55:32–38

    Article  PubMed  Google Scholar 

  39. Skippage P, Wilkinson L, Allen S, Roche N, Dowsett M, Hern R (2012) Correlation of age and HRT use with breast density as assessed by Quantra™. Breast J 19:79–86

    Article  PubMed  Google Scholar 

  40. Hammann-Kloss JS, Bick U, Fallenberg E, Engelken F (2014) Volumetric quantification of the effect of aging and hormone replacement therapy on breast composition from digital mammograms. Eur J Radiol 83:1092–1097

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This research was supported in part by Grant No. W81XWH 10 1 0993 from the Department of Defense, U.S. Army Medical Research and Materiel Command. The c-peptide assay was conducted in the Endocrine Core Laboratory of Meharry Medical College, funded in part by the National Institutes of Health via the Grant Nos. P20RR011792 and U54RR019192. The authors wish to thank the subjects and study staff (Mary Kay Fadden, Raquel Mack, Cynthia Harris, Jacqueline Favours, Asia Jones, Tierra Dennis, Melanie Velazquez, Lauren Cooper, Saima Faisal, Whitney Lovett, Helen Howse Cunningham, Merlicia Harden, Veronica Johnson, Kimberly Vaughn, Mechelle Tuck, and Nancy Harker) for their invaluable assistance with the project.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Family and Community Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN, 37208, USA

    Maureen Sanderson, Heather O’Hara & Nia Foderingham

  2. Vanderbilt University Medical Center, Nashville, TN, 37203, USA

    William D. Dupont, Xiao-Ou Shu, Neeraja Peterson & Alecia M. Fair

  3. Department of Radiology, Meharry Medical College, Nashville, USA

    Anthony C. Disher

Authors
  1. Maureen Sanderson
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  2. Heather O’Hara
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  3. Nia Foderingham
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  4. William D. Dupont
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  5. Xiao-Ou Shu
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  6. Neeraja Peterson
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  7. Alecia M. Fair
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  8. Anthony C. Disher
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Correspondence to Maureen Sanderson.

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Sanderson, M., O’Hara, H., Foderingham, N. et al. Type 2 diabetes and mammographic breast density among underserved women. Cancer Causes Control 26, 303–309 (2015). https://doi.org/10.1007/s10552-014-0502-3

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  • DOI: https://doi.org/10.1007/s10552-014-0502-3

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