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Review
. 2016 Nov;49(6):367-375.
doi: 10.3961/jpmph.16.054. Epub 2016 Oct 21.

Breast Density and Risk of Breast Cancer in Asian Women: A Meta-analysis of Observational Studies

Jong-Myon Bae  1 , Eun Hee Kim  1
Affiliations
Review

Breast Density and Risk of Breast Cancer in Asian Women: A Meta-analysis of Observational Studies

Jong-Myon Bae et al. J Prev Med Public Health. 2016 Nov.

Abstract

Objectives: The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women.

Methods: PubMed and Scopus were searched, and the final date of publication was set as December 31, 2015. The effect size in each article was calculated using the interval-collapse method. Summary effect sizes (sESs) and 95% confidence intervals (CIs) were calculated by conducting a meta-analysis applying a random effect model. To investigate the dose-response relationship, random effect dose-response meta-regression (RE-DRMR) was conducted.

Results: Six analytical epidemiology studies in total were selected, including one cohort study and five case-control studies. A total of 17 datasets were constructed by type of breast density index and menopausal status. In analyzing the subgroups of premenopausal vs. postmenopausal women, the percent density (PD) index was confirmed to be associated with a significantly elevated risk for breast cancer (sES, 2.21; 95% CI, 1.52 to 3.21; I2=50.0%). The RE-DRMR results showed that the risk of breast cancer increased 1.73 times for each 25% increase in PD in postmenopausal women (95% CI, 1.20 to 2.47).

Conclusions: In Asian women, breast cancer risk increased with breast density measured using the PD index, regardless of menopausal status. We propose the further development of a breast cancer risk prediction model based on the application of PD in Asian women.

Keywords: Breast neoplasms; Mammography; Meta-analysis; Risk factors.

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Conflict of interest statement

The authors have no conflicts of interest associated with the material presented in this paper.

Figures

Figure. 1.
Figure. 1.
The flow chart of article selection for systematic review.
Figure. 2.
Figure. 2.
The forest plot by menopausal status and kinds of density index. ES, effect size; PreM, premenopausal; PostM, postmenopausal; PD, percent density (%); TBA, total breast area (cm2).
See this image and copyright information in PMC

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