+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Prognostic significance of mammographic density change after initiation of tamoxifen for ER-positive breast cancer

Prognostic significance of mammographic density change after initiation of tamoxifen for ER-positive breast cancer

Journal of the National Cancer Institute 107(3)

A prior analysis of postmenopausal breast cancer patients linked a decline in mammographic density (MD) following the initiation of tamoxifen treatment with improved survival, but excluded premenopausal women, for whom tamoxifen is the primary anti-endocrine therapy. Therefore, we evaluated change in MD after tamoxifen and breast cancer death among patients age 32 to 87 years. This case-control study included 349 estrogen receptor (ER)-positive breast cancer patients who were treated with tamoxifen at Kaiser Permanente Northwest (1990-2008): 97 who died from breast cancer (case patients) and 252 who did not (control patients), matched on age and year at diagnosis and disease stage. Percent MD in the unaffected breast was measured at baseline (mean six months before tamoxifen initiation) and follow-up (mean 12 months after initiation). Associations between change in MD and breast cancer death were estimated using conditional logistic regression. Patients in the highest tertile of MD decline had a lower risk of breast cancer death when compared with women in the lowest tertile (odds ratio [OR] = 0.44, 95% confidence interval [CI] = 0.22 to 0.88); results were similar after adjustment for baseline MD (OR = 0.49, 95% CI = 0.23 to 1.02). Reductions in death were observed only among patients in the middle and upper tertiles of baseline MD. Associations did not differ by age, tamoxifen use duration, estrogen and/or progestin use, body mass index, or receipt of chemotherapy or radiotherapy. These data suggest that younger and older ER-positive breast cancer patients who experience large reductions in MD following tamoxifen initiation have an improved prognosis.

(PDF emailed within 0-6 h: $19.90)

Accession: 058637187

Download citation: RISBibTeXText

PMID: 25663687

DOI: 10.1093/jnci/dju425

Related references

Longitudinal Change in Mammographic Density among ER-Positive Breast Cancer Patients Using Tamoxifen. Cancer Epidemiology, Biomarkers and Prevention 25(1): 212-216, 2016

Adjuvant tamoxifen-induced mammographic breast density reduction as a predictor for recurrence in estrogen receptor-positive premenopausal breast cancer patients. Breast Cancer Research and Treatment 142(3): 559-567, 2014

Mammographic density changes following discontinuation of tamoxifen in premenopausal women with oestrogen receptor-positive breast cancer. European Radiology 28(8): 3176-3184, 2018

Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer. Journal of Clinical Oncology 31(18): 2249-2256, 2013

Can tamoxifen cause a significant mammographic density change in breast parenchyma?. Clinical Imaging 25(5): 303-308, 2001

Prognostic significance of Ki-67 labeling index after short-term presurgical tamoxifen in women with ER-positive breast cancer. Annals of Oncology 22(3): 582-587, 2011

Tamoxifen, mammographic density, and breast cancer prevention. Journal of the National Cancer Institute 103(9): 704-705, 2011

Tamoxifen in women with breast cancer and mammographic density. European Journal of Gynaecological Oncology 29(6): 598-601, 2009

Relationship between mammographic breast density and tamoxifen in women with breast cancer. Breast Journal 10(4): 313-317, 2004

The Potential for Mammographic Breast Density Change as a Biosensor of Adjuvant Tamoxifen Therapy Adherence and Response. Jnci Cancer Spectrum 2(4): Pky072, 2019

Prognostic contribution of mammographic breast density and HER2 overexpression to the Nottingham Prognostic Index in patients with invasive breast cancer. Bmc Cancer 16(1): 833, 2016

Mammographic breast density, dense area and change in breast density with breast cancer risk A matched case-control study using modern mammography. Proceedings of the American Association for Cancer Research Annual Meeting 43: 234, 2002

Breast tenderness after initiation of conjugated equine estrogens and mammographic density change. Breast Cancer Research and Treatment 131(3): 969-979, 2012

Tamoxifen modifies mammographic density, a noninvasive marker of breast cancer risk. Breast Cancer Research & Treatment 69(3): 225, 2001

Baseline mammographic breast density and the risk of invasive breast cancer in postmenopausal women participating in the NSABP study of tamoxifen and raloxifene (STAR). Cancer Prevention Research 5(11): 1321-1329, 2013