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Gestational diabetes, type II diabetes, and mammographic breast density in a U.S. racially diverse population screened for breast cancer

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Abstract

Purpose

Type II diabetes mellitus (T2DM) has consistently been associated with an increased risk of breast cancer, but the association of gestational diabetes mellitus (GDM) with breast cancer is less clear. T2DM and GDM may influence breast cancer risk through mammographic breast density, a strong risk factor for breast cancer. We examined whether T2DM and GDM are associated with higher mammographic breast density in a largely racial/ethnic minority sample.

Methods

We collected digital mammograms, anthropometric measures, and interview data from 511 racially diverse women recruited during screening mammography appointments between 2012 and 2016 (mean age 51 years; 70% Hispanic). We examined the associations of self-reported GDM, T2DM, and medication use (metformin and insulin) with mammographic breast density, measured as percent and area of dense tissue using Cumulus software.

Results

In multivariable linear regression models, history of T2DM and/or GDM and length of time since diagnosis were not associated with percent density or dense breast area, either before or after adjustment for current BMI. Use of metformin in diabetic women was associated with lower percent density (β = − 5.73, 95% CI − 10.27, − 1.19), only before adjusting for BMI. These associations were not modified by menopausal status.

Conclusions

Our results do not support associations between T2DM and/or GDM and higher amount of mammographically dense breast tissue, suggesting that the mechanism linking diabetes with breast cancer risk may not include mammographic breast density in midlife.

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Funding

This work was supported by grants from the National Cancer Institute [K07 CA151777] and the Susan G. Komen Breast Cancer Foundation [KG110331].

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Authors and Affiliations

  1. Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA

    Sabine Oskar, Aisia R. Azus & Parisa Tehranifar

  2. Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA

    Natalie J. Engmann

  3. Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA

    Parisa Tehranifar

Authors
  1. Sabine Oskar
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  2. Natalie J. Engmann
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  3. Aisia R. Azus
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  4. Parisa Tehranifar
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Corresponding author

Correspondence to Parisa Tehranifar.

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The authors declare that they have no potential conflict of interest.

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Oskar, S., Engmann, N.J., Azus, A.R. et al. Gestational diabetes, type II diabetes, and mammographic breast density in a U.S. racially diverse population screened for breast cancer. Cancer Causes Control 29, 731–736 (2018). https://doi.org/10.1007/s10552-018-1048-6

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  • DOI: https://doi.org/10.1007/s10552-018-1048-6

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