Fatty liver disease and changes in dense breasts in pre- and postmenopausal women: the Kangbuk Samsung health study
Fatty liver disease and changes in dense breasts in pre- and postmenopausal women: the Kangbuk Samsung health study
Purpose: While increased breast density is a risk factor for breast cancer, the effect of fatty liver disease on breast density is unknown. We investigated whether fatty liver is a risk factor for changes in breast density over ~ 4 years of follow-up in pre- and postmenopausal women. Methods: This study included 74,781 middle-aged Korean women with mammographically determined dense breasts at baseline. Changes in dense breasts were identified by more screening mammograms during follow-up. Hepatic steatosis (HS) was measured using ultrasonography. Flexible parametric proportional hazards models were used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs), and a Weibull accelerated failure time model (AFT) was used to determine the time ratios (TRs) and 95% CIs. Results: During a median follow-up of 4.1 years, 4022 women experienced resolution of the dense breasts. The association between HS and dense breast resolution differed by the menopause status (P for interaction < 0.001). After adjusting for body mass index and other covariates, the aHRs (95% CI) for dense breast resolution comparing HS to non-HS were 0.81 (0.70–0.93) in postmenopausal women, while the association was converse in premenopausal women with the corresponding HRs of 1.30 (1.18–1.43). As an alternative approach, the multivariable-adjusted TR (95% CI) for dense breast survival comparing HS to non-HS were 0.81 (0.75–0.87) and 1.19 (1.06–1.33) in premenopausal and postmenopausal women, respectively. Conclusion: The association between HS and changes in dense breasts differed with the menopause status. HS increased persistent dense breast survival in postmenopausal women but decreased it in premenopausal women.
Cohort study, Dense breast, Mammogram, Mammographic breast density, Persistent dense breast, Resolution of dense breast
343-353
Cho, Yoosun
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Chang, Yoosoo
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Jung, Hyun-Suk
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Kim, Chan-won
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Oh, Hyungseok
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Kim, Eun Young
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Shin, Hocheol
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Wild, Sarah W
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Byrne, Christopher
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Ryu, Seungho
fb15aa22-0789-4996-af49-8728d9813c5d
November 2021
Cho, Yoosun
368826cc-72c3-4952-af96-cda492d9d7f0
Chang, Yoosoo
fb3e523c-068d-40c8-be03-ece764c455ce
Jung, Hyun-Suk
aa2a1705-76ce-4f48-9b1e-9453ba2888f9
Kim, Chan-won
9b8b53d5-6b6e-4808-87de-d33cfd1e7d18
Oh, Hyungseok
1ba7097d-6516-43e1-809a-3edf87528a32
Kim, Eun Young
a102d7cd-0415-4ce1-99a7-13e649f308eb
Shin, Hocheol
f212e720-06fe-4725-a781-ef7a087c923e
Wild, Sarah W
04b67b11-40d0-429a-8dc0-ef6dc97b1392
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
fb15aa22-0789-4996-af49-8728d9813c5d
Cho, Yoosun, Chang, Yoosoo, Jung, Hyun-Suk, Kim, Chan-won, Oh, Hyungseok, Kim, Eun Young, Shin, Hocheol, Wild, Sarah W, Byrne, Christopher and Ryu, Seungho
(2021)
Fatty liver disease and changes in dense breasts in pre- and postmenopausal women: the Kangbuk Samsung health study.
Breast Cancer Research and Treatment, 190 (2), .
(doi:10.1007/s10549-021-06349-7).
Abstract
Purpose: While increased breast density is a risk factor for breast cancer, the effect of fatty liver disease on breast density is unknown. We investigated whether fatty liver is a risk factor for changes in breast density over ~ 4 years of follow-up in pre- and postmenopausal women. Methods: This study included 74,781 middle-aged Korean women with mammographically determined dense breasts at baseline. Changes in dense breasts were identified by more screening mammograms during follow-up. Hepatic steatosis (HS) was measured using ultrasonography. Flexible parametric proportional hazards models were used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs), and a Weibull accelerated failure time model (AFT) was used to determine the time ratios (TRs) and 95% CIs. Results: During a median follow-up of 4.1 years, 4022 women experienced resolution of the dense breasts. The association between HS and dense breast resolution differed by the menopause status (P for interaction < 0.001). After adjusting for body mass index and other covariates, the aHRs (95% CI) for dense breast resolution comparing HS to non-HS were 0.81 (0.70–0.93) in postmenopausal women, while the association was converse in premenopausal women with the corresponding HRs of 1.30 (1.18–1.43). As an alternative approach, the multivariable-adjusted TR (95% CI) for dense breast survival comparing HS to non-HS were 0.81 (0.75–0.87) and 1.19 (1.06–1.33) in premenopausal and postmenopausal women, respectively. Conclusion: The association between HS and changes in dense breasts differed with the menopause status. HS increased persistent dense breast survival in postmenopausal women but decreased it in premenopausal women.
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BREA-D-21-00272R2_manuscript_clean
- Accepted Manuscript
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BREA-D-21-00272R2_Supplementary_Tables
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More information
Accepted/In Press date: 30 July 2021
e-pub ahead of print date: 16 September 2021
Published date: November 2021
Additional Information:
Funding Information:
We thank our staff members at the Kangbuk Samsung Health Study for their hard work, dedication, and continuing support. This paper was supported by the National Research Foundation of Korea, funded by the Ministry of Science, ICT, & Future Planning (NRF-2017R1A2B2008401). This paper was supported by SKKU Excellence in Research Award Research Fund, Sungkyunkwan University, 2020. CDB is supported in part by the Southampton National Institute for Health Research Biomedical Research Centre (IS-BRC-20004).
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords:
Cohort study, Dense breast, Mammogram, Mammographic breast density, Persistent dense breast, Resolution of dense breast
Identifiers
Local EPrints ID: 450594
URI: http://eprints.soton.ac.uk/id/eprint/450594
ISSN: 0167-6806
PURE UUID: 4146fc3c-26a0-4aff-8c74-5007254fa7d8
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Date deposited: 04 Aug 2021 16:35
Last modified: 17 Mar 2024 06:45
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Contributors
Author:
Yoosun Cho
Author:
Yoosoo Chang
Author:
Hyun-Suk Jung
Author:
Chan-won Kim
Author:
Hyungseok Oh
Author:
Eun Young Kim
Author:
Hocheol Shin
Author:
Sarah W Wild
Author:
Seungho Ryu
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