Geographic variation in volumetric breast density between screening regions in the Netherlands
- Resource Type
- Authors
- Gerard J. den Heeten; Carla H. van Gils; Ruud M. Pijnappel; Daniëlle van der Waal; André L. M. Verbeek; Mireille J. M. Broeders; Marleen J. Emaus; Wouter B. Veldhuis; Marije F. Bakker; Nico Karssemeijer
- Source
- European Radiology, 25(11), 3328. Springer Verlag
European Radiology, 25, 3328-37
European radiology, 25(11), 3328-3337. Springer Verlag
European Radiology
European Radiology, 25, 11, pp. 3328-37
- Subject
- HORMONE-REPLACEMENT THERAPY
Geographic variation
030218 nuclear medicine & medical imaging
Breast cancer screening
0302 clinical medicine
MARKERS
Residence Characteristics
Breast
skin and connective tissue diseases
Mammographic density
Early Detection of Cancer
Breast Density
Netherlands
education.field_of_study
medicine.diagnostic_test
FILM MAMMOGRAPHY
MAMMOGRAPHIC DENSITY
General Medicine
ASSOCIATION
Middle Aged
Clinical Trial
Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
3. Good health
Multicenter Study
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
Female
Radiology
Mammography
Adult
medicine.medical_specialty
Digital mammography
Population
Socio-economic status
UNITED-STATES
Breast Neoplasms
Urbanisation
03 medical and health sciences
medicine
Journal Article
Humans
Radiology, Nuclear Medicine and imaging
Breast density
education
Mammary Glands, Human
METAANALYSIS
Aged
Gynecology
CANCER RISK
business.industry
PERFORMANCE
FIELD DIGITAL MAMMOGRAMS
Linear Models
business
Regional differences
Demography
- Language
- ISSN
- 0938-7994
Contains fulltext : 152266.pdf (Publisher’s version ) (Open Access) OBJECTIVES: Differences in breast density between populations may explain part of the variation in regional breast cancer screening performance. This study aimed to determine whether regional differences in breast density distribution are present in the Dutch screening population. METHODS: As part of the DENSE trial, mammographic density was measured using a fully-automated volumetric method. The regions in our study were based on the geographic coverage of 14 reading units representing a large part of the Netherlands. General linear models were used. RESULTS: Four hundred eighty-five thousand and twenty-one screening participants with a median age of 60 years were included (2013-2014). The proportion of women with heterogeneously or extremely dense breasts ranged from 32.5 % to 45.7 % between regions. Mean percent dense volume varied between 6.51 % (95 % confidence interval [CI]: 6.46-6.55) and 7.68 % (95 % CI: 7.66-7.71). Age differences could not explain the variation. Socio-economic status (SES) was positively associated with volumetric density in all analyses (low SES: 6.95 % vs. high SES: 7.63 %; p trend < 0.0001), whereas a potential association between urbanisation and breast density only became apparent after SES adjustment. CONCLUSION: There appears to be geographic variation in mammographic density in the Netherlands, emphasizing the importance of including breast density as parameter in the evaluation of screening performance. KEY POINTS: * Mammographic density may affect regional breast cancer screening performance. * Volumetric breast density varies across screening areas. * SES is positively associated with breast density. * Implications of volumetric breast density differences need to be studied further.