The relationship between breast density and clinical and pathological findings in Turkish female patients with breast cancer

Yıl 2022, Cilt 15, Sayı 2, 309 - 317, 01.04.2022

Nihan TURHAN Dilek YILMAZ Levent YEŞİLYURT

https://doi.org/10.31362/patd.982998

Öz

Purpose: Breast cancer is one of the leading causes of cancer-related death in women all over the world. Studies on the ethiology of breast cancer have been carried out for many years. With the demonstration of the radiological breast density as a risk factor on breast cancer, studies on this subject have been accelerated. Studies have shown that breast density varies between societies with different ethnic origins. In our study, the relationship between breast density and breast cancer in Turkish breast cancer patients is investigated.
Materials and methods: In our study, breast density, age, menopausal status, body mass index and pathological features of the tumor were evaluated retrospectively in Turkish breast cancer patients treated in our hospital between 01.01.2018-01.01.2021.
Results: According to the data obtained, it has been shown that breast density is statistically significantly lower as age increases, in the post-menopausal period and as body mass index increases. However, no significant relationship was found between breast density and tumor size and pathological markers.
Conclusion: Breast density is a risk factor for breast cancer that can be changed and modified throughout the life of the individual, primarily by obesity and hormonal changes. Patients with dense breast should be identified, taken measures to reduce the risk of breast cancer and followed more frequently with additional imaging methods if necessary.

Anahtar Kelimeler

Breast cancer, breast density, pathology

Meme kanseri olan Türk kadın hastalarda meme dansitesinin klinik ve patolojik bulgularla ilişkileri

Öz

Amaç: Meme kanseri, kadınlarda kansere bağlı ölüm nedenleri arasında tüm dünyada çok büyük bir tehdit oluşturmaktadır. Uzun yıllardır meme kanseri etiyolojisine yönelik çalışmalar yapılmaktadır. Memenin radyolojik dansite yoğunluğunun meme kanseri üzerinde etkili olduğunun gösterilmesi ile bu konuda çalışmalar hızlanmıştır. Yapılan çalışmalarda meme dansitesinin farklı etnik kökenli toplumlar arasında değişiklikler gösterdiği sunulmuştur. Çalışmamızda Türk uyruklu meme kanseri hastalarının meme dansiteleri ile meme kanseri ilişkisi araştırılmıştır.
Gereç ve yöntem: Çalışmamızda 01.01.2018-01.01.2021 tarihleri arasında hastanemizde tedavi edilen Türk uyruklu meme kanseri hastalarında meme dansitesi, yaş, menopoz durumu, vücut kitle indeksi ve tümörün patolojik özelikleri retrospektif olarak değerlendirilmiştir.
Bulgular: Elde edilen veriler ışığında meme dansitesinin yaş arttıkça ve post-menopozal dönemde ve vücut kitle indeksinin arttığı durumlarda istatistiksel açıdan anlamlı olarak düşük olduğu gösterilmiştir. Ancak meme dansitesi ile tümör boyutu ve patolojik belirteçler arasında anlamlı bir ilişki saptanamamıştır.
Sonuç: Meme dansitesi, meme kanseri için başta obezite durumu ve hormonal değişimler ile bireyin ömrü boyunca değişen ve modifiye edilebilen bir risk faktörüdür. Meme dansitesi yoğun hastaların tanınması, meme kanseri riskini azaltıcı önlemlerin alınması ve gereklilik halinde ek görüntüleme yöntemleri ile daha sık aralıklarla izlenmeleri gerekmektedir.

Anahtar Kelimeler

Meme kanseri, meme dansitesi, patoloji

Kaynakça

• Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015 Mar;65(2):87-108. doi: 10.3322/caac.21262. Epub 2015 Feb 4. PMID: 25651787.
• Özmen V. Breast Cancer in Turkey: Clinical and histopathological characteristics (Analysis of 13.240 Patients). J Breast Health. 2014 Apr 1;10(2):98-105. doi: 10.5152/tjbh.2014.1988. PMID: 28331652; PMCID: PMC5351477.
• Özmen V, Özmen T, Doğru V. Breast cancer in Turkey; an analysis of 20.000 patients with breast cancer. Eur J Breast Health. 2019 Jul 1;15(3):141-146. doi: 10.5152/ejbh.2019.4890. Erratum in: Eur J Breast Health. 2019 Oct 01;15(4):276. PMID: 31312788; PMCID: PMC6619786.
• Rojas K, Stuckey A. Breast cancer epidemiology and risk factors. Clin Obstet Gynecol. 2016 Dec;59(4):651-672. doi: 10.1097/GRF.0000000000000239. PMID: 27681694.
• Fortner RT, Katzke V, Kühn T, Kaaks R. Obesity and breast cancer. Recent results Cancer Res. 2016;208:43-65. doi: 10.1007/978-3-319-42542-9_3. PMID: 27909901.
• Huo CW, Chew GL, Britt KL,ve ark. Mammographic density-a review on the current understanding of its association with breast cancer. Breast Cancer Res Treat. 2014 Apr;144(3):479-502. doi: 10.1007/s10549-014-2901-2. Epub 2014 Mar 11. PMID: 24615497.
• McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1159-69. doi: 10.1158/1055-9965.EPI-06-0034. PMID: 16775176.
• Sherratt MJ, McConnell JC, Streuli CH. Raised mammographic density: causative mechanisms and biological consequences. Breast Cancer Res. 2016 May 3;18(1):45. doi: 10.1186/s13058-016-0701-9. PMID: 27142210; PMCID: PMC4855337.
• Huo CW, Chew G, Hill P, ve ark. High mammographic density is associated with an increase in stromal collagen and immune cells within the mammary epithelium. Breast Cancer Res. 2015 Jun 4;17(1):79. doi: 10.1186/s13058-015-0592-1. PMID: 26040322; PMCID: PMC4485361.
• Shaikh AJ, Mullooly M, Sayed S,ve ark. Mammographic breast density and breast cancer molecular subtypes: The Kenyan-African aspect. Biomed Res Int. 2018 Jan 22;2018:6026315. doi: 10.1155/2018/6026315. PMID: 29607324; PMCID: PMC5828539.
• Salem C, Atallah D, Safi J,ve ark. Breast density and breast cancer incidence in the Lebanese population: results from a retrospective multicenter study. Biomed Res Int. 2017;2017:7594953. doi: 10.1155/2017/7594953. Epub 2017 Jul 2. PMID: 28752096; PMCID: PMC5511666.
• Penault-Llorca F, Radosevic-Robin N. Ki67 assessment in breast cancer: an update. Pathology. 2017 Feb;49(2):166-171. doi: 10.1016/j.pathol.2016.11.006. Epub 2017 Jan 5. PMID: 28065411.
• Boyd NF, Martin LJ, Yaffe MJ, Minkin S. Mammographic density: a hormonally responsive risk factor for breast cancer. J Br Menopause Soc. 2006 Dec;12(4):186-93. doi: 10.1258/136218006779160436. PMID: 17178021.
• Chiu SY, Duffy S, Yen AM, Tabár L, Smith RA, Chen HH. Effect of baseline breast density on breast cancer incidence, stage, mortality, and screening parameters: 25-year follow-up of a Swedish mammographic screening. Cancer Epidemiol Biomarkers Prev. 2010 May;19(5):1219-28. doi: 10.1158/1055-9965.EPI-09-1028. Epub 2010 Apr 20. PMID: 20406961.
• Pettersson A, Graff RE, Ursin G,ve ark. Mammographic density phenotypes and risk of breast cancer: a meta-analysis. J Natl Cancer Inst. 2014 May 10;106(5):dju078. doi: 10.1093/jnci/dju078. PMID: 24816206; PMCID: PMC4568991.
• Johns PC, Yaffe MJ. X-ray characterisation of normal and neoplastic breast tissues. Phys Med Biol. 1987 Jun;32(6):675-95. doi: 10.1088/0031-9155/32/6/002. PMID: 3039542.
• Oliver A, Tortajada M, Lladó X,ve ark. Breast density analysis using an automatic density segmentation algorithm. J Digit Imaging. 2015 Oct;28(5):604-12. doi: 10.1007/s10278-015-9777-5. PMID: 25720749; PMCID: PMC4570891.
• Destounis SV, Santacroce A, Arieno A. Update on breast density, risk estimation, and supplemental screening. AJR Am J Roentgenol. 2020 Feb;214(2):296-305. doi: 10.2214/AJR.19.21994. Epub 2019 Nov 19. PMID: 31743049.
• Engmann NJ, Scott CG, Jensen MR, ve ark. Combined effect of volumetric breast density and body mass index on breast cancer risk. Breast Cancer Res Treat. 2019 Aug;177(1):165-173. doi: 10.1007/s10549-019-05283-z. Epub 2019 May 25. PMID: 31129803; PMCID: PMC6640105.
• Ursin G, Lillie EO, Lee E,ve ark. The relative importance of genetics and environment on mammographic density. Cancer Epidemiol Biomarkers Prev. 2009 Jan;18(1):102-12. doi: 10.1158/1055-9965.EPI-07-2857. PMID: 19124487.
• Crest AB, Aiello EJ, Anderson ML, Buist DS. Varying levels of family history of breast cancer in relation to mammographic breast density (United States). Cancer Causes Control. 2006 Aug;17(6):843-50. doi: 10.1007/s10552-006-0026-6. PMID: 16783612.
• Ma I, Dueck A, Gray R,ve ark. Clinical and self breast examination remain important in the era of modern screening. Ann Surg Oncol. 2012 May;19(5):1484-90. doi: 10.1245/s10434-011-2162-9. Epub 2011 Dec 8. PMID: 22160521.
• Bae JM, Kim EH. Breast density and risk of breast cancer in Asian women: a meta-analysis of observational studies. J Prev Med Public Health. 2016 Nov;49(6):367-375. doi: 10.3961/jpmph.16.054. Epub 2016 Oct 21. PMID: 27951629; PMCID: PMC5160133.
• Phi XA, Tagliafico A, Houssami N, Greuter MJW, de Bock GH. Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis. BMC Cancer. 2018 Apr 3;18(1):380. doi: 10.1186/s12885-018-4263-3. PMID: 29615072; PMCID: PMC5883365.
• Arora N, King TA, Jacks LM,ve ark. Impact of breast density on the presenting features of malignancy. Ann Surg Oncol. 2010 Oct;17 Suppl 3:211-8. doi: 10.1245/s10434-010-1237-3. Epub 2010 Sep 19. PMID: 20853035.
• Duffy SW, Morrish OWE, Allgood PC, ve ark. Mammographic density and breast cancer risk in breast screening assessment cases and women with a family history of breast cancer. Eur J Cancer. 2018 Jan;88:48-56. doi: 10.1016/j.ejca.2017.10.022. Epub 2017 Nov 27. PMID: 29190506; PMCID: PMC5768323.