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Lifecourse predictors of mammographic density: The Newcastle Thousand Families cohort Study
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Professor Mark Pearce
Dr Kay Mann
Professor Louise Parker
Pearce MS, Tennant PWG, Mann KD, Pollard TM, McLean L, Kaye B, Parker L
Breast Cancer Research and Treatment
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Dense mammographic patterns are a strong predictor of breast cancer risk. A range of factors at different stages of life have been linked to breast cancer risk, although rarely studied simultaneously. We aimed to study whether birth weight and factors later in life were associated with mammographic density in the Newcastle Thousand Families birth cohort.
The Newcastle Thousand Families Study is a prospective study which originally consisted of all 1142 babies born in May and June 1947 to mothers resident in Newcastle upon Tyne in Northern England. Detailed information was collected prospectively during childhood, including birth weight and socio-economic circumstances.
At age 49-51 years, 574 study members completed a detailed ‘Health and Lifestyle’ questionnaire. Of the 307 surviving women who returned these questionnaires, 199 returned a further questionnaire asking for details of routine mammographic screening and for details of their reproductive and contraceptive history. Mammographic patterns were coded into Wolfe categories (lowest, low, high and highest risks). This was analysed, by ordinal logistic regression, in relation to a range of variables at different stages of life.
Increased standardised birth weight (adjusted odds ratio, aOR= 1.32 (95% CI: 1.02, 1.71) p=0.03) was a significant independent predictor of being in a higher density group. In contrast, increasing body mass index was independently predictive of being in a lower density group (aOR=0.86 per Kg/m
(95% CI 0.81, 0.92) p<0.001), as was having reached menopause (aOR, compared to pre and peri--menopausal women=0.41 (95% CI 0.23,0.73) p=0.002). Borderline significant interactions were seen between menopausal status and both BMI and age at menarche (p=0.06) on density.
After adjustment for factors acting throughout life, we identified a significant association between increased birth weight, standardised for sex and gestational age, and increased mammographic density in adulthood.
This is consistent with previous research suggesting that heavier babies have an increased risk of breast cancer in later life. We also confirm associations between both BMI and menopausal status and report interactions that confirm the change in risk associated with differing levels of BMI for pre and post-menopausal breast cancer.
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