Association Between Body Mass Index and Breast Density Using Digital Mammography

체질량지수와 디지털유방촬영술상의 유방밀도와의 연관성

  • Kim, Mi-Young (Department of Diagnostic Radiology, Dankook University Hospital) ;
  • Kim, Hwa-Sun (Department of Radiological Technology, Ansan University)
  • 김미영 (단국대학교병원 영상의학과) ;
  • 김화선 (안산대학교 방사선과)
  • Received : 2014.10.27
  • Accepted : 2014.12.12
  • Published : 2014.12.31

Abstract

It is well known that low body mass index and younger age are associated with high breast density. Mammographic dense breast has been reported both as a cause of false-negative findings on mammography and as an indicator of increased breast cancer risk. The purpose of this study was to evaluate the association between breast density and body mass index. Furthermore, we considered proper screening method of breast cancer in Korean women. The study was performed on 496 women who underwent health checkup in a university hospital. Age and body mass index were negatively associated with breast density respectively. In postmenopausal women, age and body mass index showed statistically significant association with breast density. Therefore, we should consider sensitive additional method for breast cancer screening especially in younger age and underweight women.

이 연구의 목적은 무증상 여성을 대상으로 폐경 여부에 따라 체질량지수에 따른 유방밀도의 분포양상을 분석하여 선별유방검사방법 선택에 도움을 주는 것이다. 496명의 여성을 대상으로 유방촬영술을 시행하여 유방밀도를 분류해 분석한 결과는 다음과 같다. 40대 이하의 젊은 여성의 경우 치밀유방의 비율이 높은 것으로 나타났으며, 연령이 증가할수록 유방밀도는 감소하는 것으로 나타났다. 체질량지수에 따른 유방밀도 분포는 체질량지수가 증가함에 따라 유방밀도가 감소하는 것으로 나타났다. 폐경여부에 따라 유방밀도에 영향을 미치는 비만관련 요인을 알아 본 결과 폐경 후 여성에서는 연령과 체질량지수가 상관관계가 있는 것으로 나타났으나, 폐경 전 여성에서는 뚜렷한 상관관계가 있는 요인이 나타나지 않았다. 따라서 유방암 선별검사 선택 시 젊은 여성의 유방암의 발생비율과 치밀유방의 비율이 높은 우리나라의 특성을 고려한 개별적인 검진방법을 선택하는 것이 필요하겠으며, 젊고 마른 여성의 경우 유방초음파를 병행한다면 검사의 민감도를 보완할 수 있을 것이다.

Keywords

References

  1. 대한유방암학회: 2013 유방암백서통권제1호. 2013
  2. Mcpherson K, Steel CM, Dixon JM: ABC of Breast Diseases. Breast Cancer-Epidemiology, Risk Factors and Genetics. BMJ. 321, 624-628, 2000 https://doi.org/10.1136/bmj.321.7261.624
  3. Bradbury A, Olopade OI: The Case for Individualized Screening Recommendations for Breast Cancer. J Clin Oncol., 24(21), 3328-3330, 2006 https://doi.org/10.1200/JCO.2006.05.8586
  4. Warwick J, Pinney E, Warren RM, Duffy SW, Howell A, Wilson M, et al: Breast Density and Breast Cancer Risk Factors in a High-Risk Population. Breast., 12(1), 10-16, 2003 https://doi.org/10.1016/S0960-9776(02)00212-6
  5. Garney PA, Miglioretti DL, Yankaskas BC, Kerlikowske K, Rosenberg R, Rutter CM, et al: Individual and Combined Effects of Age, Breast Density and Hormone Replacement Therapy Use on the Accuracy of Screening Mammography. Ann Intern Med., 138(3), 1681-175, 2003
  6. Sellers TA, Vachon CM, Pankratz VS, Janney CA, Fredericksen Z, Brandt KR, et al: Association of Childhood and Adolescent Anthropometric Factors, Physical Activity and Diet with Adult Mammographic Breast Density. Am J Epidermiol., 166(4), 456-464, 2007 https://doi.org/10.1093/aje/kwm112
  7. Banks E, Reeves G, Beral V, Bull D, Crossley B, Simmonds M, et al: Influence of Personal Characteristics of Individual Women on Sensitivity and Specificity of Mammography in the Million Women Study: Cohort Study. BMJ., 329(7464), 477, 2004 https://doi.org/10.1136/bmj.329.7464.477
  8. Hunt KA, Sickles EA: Effect of Obesity on Screening Mammography: Outcomes Analysis of 88,346 Consecutive Examinations. AJR Am J Roentgenol., 174(5), 2151-2155, 2000
  9. Carney PA, Miglioretti DL, Yankaskas BC, Kerlikowske K, Rosenberg R, Rutter CM, et al: Individual and Combined Effects of Age, Breast Density and Hormone Replacement Therapy Use on the Accuracy of Screening Mammography. Ann Intern Med., 138(3), 168-175, 2003 https://doi.org/10.7326/0003-4819-138-3-200302040-00008
  10. Kerlilowske K, Grady D, Barclay J, Sickles EA, Ernster V: Effect of Age, Breast Density and Family History on the Sensitivity of First Screening Mammography. JAMA., 276(1), 33-38, 1996 https://doi.org/10.1001/jama.1996.03540010035027
  11. Carney PA, Kasales CJ, Tosteson ANA, Weiss JE, Goodrich ME, Poplack SP, et al: Likelihood of Additional Work-up among Women Undergoing Routine Screening Mammography: The Impact of Age, Breast Density and Hormone Therapy Use. Preventive Medicine., 39(1), 48-55, 2004 https://doi.org/10.1016/j.ypmed.2004.02.025
  12. Buist DSM, Porter PL, Lehman C, Taplin SH, White E: Factors Contributing to Mammography Failure in Women Aged 40-49 Years. J Natl Cancer Inst., 96(19), 1432-1440, 2004 https://doi.org/10.1093/jnci/djh269
  13. Mandelson MT, Oestreicher N, Porter PL, White D, Finder CA, Taplin SH, et al: Breast Density as a Predictor of Mammographic Detection: Comparsion of Interval and Screen Detected Cancers. PJ Natl Cancer Inst., 92(13), 1081-1087, 2000 https://doi.org/10.1093/jnci/92.13.1081
  14. Kim SH, Kim MH, Oh KK: Analysis and Comparison of Breast Density According to Age on Mammogram between Korean and Western Women. J Korean Radiol Soc., 42(6), 1009-1014, 2000 https://doi.org/10.3348/jkrs.2000.42.6.1009
  15. Mo EH, Lim CH, Lee SH, Jung HR, Lee HN. Analysis of Mammography for Patient with Breast Cancer. J radiological science and technology., 34(1), 1-7, 2011
  16. Cho JJ, Song HJ, Koh EY, Song YM, Han BK, Yun YS, et al: Mammographic Breast Denstiy and Risk Factors of Breast Cancer in Korean Women Using Multicenter Study. J Korean Acad Fam Med., 27, 33-41, 2006
  17. Boud NF, Martin LJ, Sun L, Guo H, Chiarelli A, Hislop G, et al: Body Size, Mammographic Density and Breast Cancer Risk. Cancer Epidermiol Biomarkers Prev., 15(11), 2086-2092, 2006 https://doi.org/10.1158/1055-9965.EPI-06-0345
  18. Goh ER, Shin KW, Seo YY, Ko JA, Park MS, Cho BR:. Breast Density in Mammography According to Body Mass Index(BMI) in Korean Women. Korean J Health Promot Dis Prev., 83(4), 281-286, 2008
  19. O'Brien SN, Anandjiwala J, Price TM: Differences in the Estrogen Content of Breast Adipose Tissue in Women by Menopausal Status and Hormone Use. Obster Gynecol., 90, 244-248, 1997 https://doi.org/10.1016/S0029-7844(97)00212-3
  20. Atkins CD: Potential Hazards of Mammography. J Clin Oncol., 25(5), 604, 2007