Mammographic density and breast cancer in BRCA1/BRCA2 carriers

Pollan, Marina

Mammographic density and breast cancer in BRCA1/BRCA2 carriers

Sunday, 17 August 2014

Exhibit hall (Dena'ina Center)

Marina Pollan, PhD , Consortium for Biomedical Research in Epidemiology & Public Health, Madrid, Spain

Teresa Ramon y Cajal, MD , Hospital Santa Creu i Sant Pau, Barcelona, Spain

Isabel Chirivella, MD , Hospital Clinico Universitario de Valencia, Valencia, Spain

Josefa Miranda, MD , Centre for Public Health Research (CSISP- FISABIO), Valencia, Spain

Alexandre Teule, MD , Hospital Duran i Reynals. Catalan Institute of Oncology-IDIBELL, Barcelona, Spain

Joan Brunet, MD , Girona Biomedical Research Institute IDIBGI, Girona, Spain

Ana Beatriz Sanchez-Heras, MD , Hospital Universitario de Elche, Elche (Alicante), Spain

Gemma Llort, MD , Corporació Sanitaria Parc Tauli; Consorci Sanitari de Terrassa, Terrassa, Spain

Judith Balmañà, MD , Hospital Vall d'Hebron, Barcelona, Spain

Virginia Carvajal, PhD , Consortium for Biomedical Research in Epidemiology & Public Health, Madrid, Spain

Elena Hernandez-Agudo, MD , Hospital La Paz, Madrid, Spain

Maria José Juan-Fita, MD , Instituto Valenciano de Oncología IVO, Valencia, Spain

Isabel Tena-García, MD , Hospital Provincial de Castellón, Castellón, Spain

Luis Robles, MD , Hospital Doce de Octubre, Madrid, Spain

Carmen Guillén, MD , Hospital Ramón y Cajal, Madrid, Spain

Pedro Pérez-Segura, MD , Hospital Clínico de San Carlos, Madrid, Spain

Mari Sol Luque-Molina, MD , Hospital Gregorio Marañón, Madrid, Spain

Susana Hernando, MD , Hospital Fundación Alcorcón, Alcorcón, Spain

INTRODUCTION:

Mammographic density (MD) is one of the strongest determinants of breast cancer (BC). In this study, we compared MD in BRCA1/2 carriers and non-carriers from BRCA1/2 families and investigate the association between MD and BC among BRCA1/2 carriers per type of mutation and tumor subtype.

METHODS:

The study was carried out in female members of BRCA1 and BRCA2 mutation-positive families seen in 16 Spanish Genetic Counseling Units. A total of 1039 women signed the informed consent and answered the questionnaire. Mammograms from 353 BRCA1-carriers, 360-BRCA2 carriers and 247 non-carriers were available and read by a single radiologist using a 5-category scale of MD (<10%, 10-25%, 25-50%, 50-75% and >75%). MD distribution in carriers and non-carriers was compared using ordinal logistic models, adjusted for age, BMI, menopause, parity, type of image and subsequent BC development. The association between MD and BC in BRCA1/2 carriers was studied using logistic regression models, adjusted for age, BMI, menopausal status, parity, type of image, time elapsed from mammogram to BC diagnosis (cases) or end of follow-up (non cases). Huber-White robust estimators of variance were used to take into account correlations between family members. A similar multinomial model was used to explore this association by BC subtype.

RESULTS:

The probability of having high MD was lower among BRCA2-carriers (OR=0.70; p-value=0.031). However, MD was associated with subsequent BC (OR per category of MD: 1.41; 95%CI: 1.15-1.73) and no differences were seen between BRCA1 and BRCA2 carriers (p-value=0.69). The association was stronger among women who had taken oral contraceptives (OR=1.54; 95%CI: 1.22-1.95). Regarding BC subtypes, no statistically significant differences were observed, but the OR was higher for triple negative tumors (OR: 1.51; 95%CI: 1.12-2.15).

CONCLUSIONS:

BRCA1/2 carriers do not present higher MD, but our work confirms that MD is also a phenotype risk marker in these women.

Grants: FIS_PS09/01006;FIS_PS09/01024;FIS_PS09/01721