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. 2022 Jul 1;31(7):1313-1323.
doi: 10.1158/1055-9965.EPI-21-1249.

Body Mass Index and Mammographic Density in a Multiracial and Multiethnic Population-Based Study

Mollie E Barnard  1 , Tarun Martheswaran  1 , Margaret Van Meter  2 , Saundra S Buys  3 , Karen Curtin #  3   4 , Jennifer Anne Doherty #  1
Affiliations

Body Mass Index and Mammographic Density in a Multiracial and Multiethnic Population-Based Study

Mollie E Barnard et al. Cancer Epidemiol Biomarkers Prev. .

Abstract

Background: Mammographic density (MD) is strongly associated with breast cancer risk. We examined whether body mass index (BMI) partially explains racial and ethnic variation in MD.

Methods: We used multivariable Poisson regression to estimate associations between BMI and binary MD [Breast Imaging Reporting and Database System (BI-RADS) A&B versus BI-RADS C&D] among 160,804 women in the Utah mammography cohort. We estimated associations overall and within racial and ethnic subgroups and calculated population attributable risk percents (PAR%).

Results: We observed the lowest BMI and highest MD among Asian women, the highest BMI among Native Hawaiian and Pacific Islander women, and the lowest MD among American Indian and Alaska Native (AIAN) and Black women. BMI was inversely associated with MD [RRBMI≥30 vs. BMI<25 = 0.43; 95% confidence interval (CI), 0.42-0.44] in the full cohort, and estimates in all racial and ethnic subgroups were consistent with this strong inverse association. For women less than 45 years of age, although there was statistical evidence of heterogeneity in associations between BMI and MD by race and ethnicity (P = 0.009), magnitudes of association were similar across groups. PAR%s for BMI and MD among women less than 45 years were considerably higher in White women (PAR% = 29.2, 95% CI = 28.4-29.9) compared with all other groups with estimates ranging from PAR%Asain = 17.2%; 95% CI, 8.5 to 25.8 to PAR%Hispanic = 21.5%; 95% CI, 19.4 to 23.6. For women ≥55 years, PAR%s for BMI and MD were highest among AIAN women (PAR% = 37.5; 95% CI, 28.1-46.9).

Conclusions: While we observed substantial differences in the distributions of BMI and MD by race and ethnicity, associations between BMI and MD were generally similar across groups.

Impact: Distributions of BMI and MD may be important contributors to breast cancer disparities.

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Conflict of interest statement

Conflict of interest statement: Dr. Barnard reports personal fees from Epi Excellence LLC outside the submitted work.

References

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    1. Utah Department of Health. Utah Health Status Update: Disparities in Cancer Incidence; July 2018. Available from: https://ibis.health.utah.gov/ibisph-view/pdf/opha/publication/hsu/2018/1....
    1. Office of Health Disparities. Health Status by Race and Ethnicity 2015 2015. Available from: https://uofuhealth.utah.edu/utah-cancer-registry/docs/2015-health-status....
    1. Boyd NF, Martin LJ, Yaffe MJ, Minkin S. Mammographic density and breast cancer risk: current understanding and future prospects. Breast Cancer Res. 2011;13(6):223. - PMC - PubMed

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