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. 2019 Feb 28;21(1):33.
doi: 10.1186/s13058-019-1113-4.

The distribution and determinants of mammographic density measures in Western Australian aboriginal women

Kirsty McLean  1 , Ellie Darcey  1 , Gemma Cadby  1 , Helen Lund  2 , Leanne Pilkington  2   3 , Andrew Redfern  4   5 , Sandra Thompson  6 , Christobel Saunders  4   5 , Elizabeth Wylie  2   4 , Jennifer Stone  7   8   9
Affiliations

The distribution and determinants of mammographic density measures in Western Australian aboriginal women

Kirsty McLean et al. Breast Cancer Res. .

Abstract

Background: Mammographic density (MD) is an established risk factor for breast cancer. There are significant ethnic differences in MD measures which are consistent with those for corresponding breast cancer risk. This is the first study investigating the distribution and determinants of MD measures within Aboriginal women of Western Australia (WA).

Methods: Epidemiological data and mammographic images were obtained from 628 Aboriginal women and 624 age-, year of screen-, and screening location-matched non-Aboriginal women randomly selected from the BreastScreen Western Australia database. Women were cancer free at the time of their mammogram between 1989 and 2014. MD was measured using the Cumulus software. Kolmogorov-Smirnov tests were used to compare distributions of absolute dense area (DA), precent dense area (PDA), non-dense area (NDA) and total breast area between Aboriginal and non-Aboriginal women. General linear regression was used to estimate the determinants of MD, adjusting for age, NDA, hormone therapy use, family history, measures of socio-economic status and remoteness of residence for Aboriginal and non-Aboriginal women separately.

Results: Aboriginal women were found to have lower DA and PDA and higher NDA than non-Aboriginal women. Age (p < 0.001) was negatively associated and several socio-economic indices (p < 0.001) were positively associated with DA and PDA in Aboriginal and non-Aboriginal women. Remoteness of residence was associated with both mammographic measures but for non-Aboriginal women only.

Conclusions: Aboriginal women have, on average, less MD than non-Aboriginal women but the factors associated with MD are similar for both sample populations. Since reduced MD is associated with improved sensitivity of mammography, this study suggests that mammographic screening is a particularly good test for Australian Indigenous women, a population that suffers from high breast cancer mortality.

Keywords: Breast cancer; Ethnicity; Indigenous women; Mammographic density; Mammographic screening; Risk factor.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained by the WA Department of Health Human Research Ethics Committee (Project #2014/50) and the WA Aboriginal Health Ethics Committee (Project 581). A waiver of informed consent was received to obtain access to de-identified linked data.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Histograms showing differences in distributions of the total area (a), non-dense area (b), absolute dense area (c) and percentage dense area (d) between Aboriginal and non-Aboriginal women for digitized film mammograms across all ages
Fig. 2
Fig. 2
Histograms showing differences in distributions of the total area (a), non-dense area (b), absolute dense area (c) and percentage dense area (d) between Aboriginal and non-Aboriginal women aged under 50 for digitized film mammograms
See this image and copyright information in PMC

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