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Mammographic density as a risk factor for breast cancer in a German case–control study

Heusinger, Katharinaa; Loehberg, Christian R.a; Haeberle, Lothara; Jud, Sebastian M.a; Klingsiek, Petera; Hein, Alexandera; Bayer, Christian M.a; Rauh, Claudiaa; Uder, Michaelb; Cavallaro, Alexanderb; May, Matthias S.b; Adamietz, Borisb; Schulz-Wendtland, Ruedigerb; Wittenberg, Thomasc; Wagner, Florianc; Beckmann, Matthias W.a; Fasching, Peter A.d

European Journal of Cancer Prevention: January 2011 - Volume 20 - Issue 1 - p 1–8
doi: 10.1097/CEJ.0b013e328341e2ce
Research Papers: Breast Cancer

Mammographic percent density (MD) is recognized as one of the strongest risk factors associated with breast cancer. This matched case–control study investigated whether MD represents an independent risk factor. Mammograms were obtained from 1025 breast cancer patients and from 520 healthy controls. MD was measured using a quantitative computer-based threshold method (0–100%). Breast cancer patients had a higher MD than healthy controls (38 vs. 32%, P<0.01). MD was significantly higher in association with factors such as age over 60 years, body mass index (BMI) of 25–30 kg/m2, nulliparity or low parity (one to two births). Average MD was inversely associated with age, BMI, parity and positively associated with age at first full-term pregnancy. MD was higher in women with at least one first-degree relative affected, but only among patients and not in the group of healthy controls (P<0.01/P=0.61). In women with an MD of 25% or more, the risk of breast cancer was doubled compared with women with an MD of less than 10% (odds ratio: 2.1; 95% confidence interval: 1.3–3.4; P<0.01); in the postmenopausal subgroup, the risk was nearly tripled (odds ratio: 2.7; 95% confidence interval: 1.6–4.7; P<0.001). This study provides further evidence that MD is an important risk factor for breast cancer. These results indicate strong associations between MD and the risk of breast cancer in a matched case–control study in Germany.

aUniversity Breast Center Franconia

bInstitute of Diagnostic Radiology, Erlangen University Hospital, Universitaetsstrasse

cFraunhofer-Institute for Integrated Circuits IIS, Am Wolfsmantel 33, Erlangen, Germany

dDepartment of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, Suite 200, Santa Monica, California, USA

Correspondence to Dr Peter A. Fasching, MD, Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, 2825 Santa Monica Building, Suite 200, Santa Monica, CA 90404, USA Tel: +1 49 9131 91880612; fax: +1 49 9131 91880618; e-mail:

Katharina Heusinger and Christian R. Loehberg have contributed equally to this study

Received July 8, 2010

Accepted October 24, 2010

© 2011 Lippincott Williams & Wilkins, Inc.