Korean J Health Promot.  2015 Dec;15(4):168-174. 10.15384/kjhp.2015.15.4.168.

Associations between Metabolic Syndrome and Three-dimensional Breast Density Using Digital Mammography

• Bhang SY
• Lee HJ
• Kang JH
• Yu BY

• KMID: 2247042
• DOI: http://doi.org/10.15384/kjhp.2015.15.4.168

Abstract

BACKGROUND
Metabolic syndrome is associated with increased risk of breast cancer, but little is known about the association between metabolic syndrome and mammographic density as an independent predictor of breast cancer. In this study, we investigated the association between metabolic syndrome or its components and three-dimensional breast density using digital mammography.
METHODS
We analyzed cross-sectional data of 166 women, aged 20 or over (61 premenopausal and 105 postmenopausal women) in a district hospital. Metabolic syndrome was defined according to the modified National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) guideline. We measured volume percentage of dense breast tissue using digital mammography. Stepwise multiple regression analysis was used to estimate the association between mammographic density and metabolic syndrome, as well as its components.
RESULTS
The Mean mammographic density was lower in the group with metabolic syndrome compared with the group without it. After adjusting for age and menopausal status, multiple regression analysis showed waist circumference (beta=-3.112, S.E.=0.927, P=0.001) and low HDL-cholesterol (beta=-2.967, S.E.=1.109, P=0.008) were independent variables for the percentage of mammographic density, although metabolic syndrome itself was not. After additional adjustment for body mass index, only low HDL-cholesterol was associated with percentage of mammographic density (beta=-2.953, S.E.=0.882, P=0.001).
CONCLUSIONS
In this study, only low HDL cholesterol was associated with three-dimensional mammographic density independently after adjusting for age, menopausal status and body mass index. These findings need to be confirmed in further larger prospective studies.

Keyword

Metabolic syndrome; Mammographic density; High density lipoprotein cholesterol; Breast cancer

MeSH Terms

Adult
Body Mass Index
Breast Neoplasms
Breast*
Cholesterol
Cholesterol, HDL
Education
Female
Hospitals, District
Humans
Mammography*
Prospective Studies
Waist Circumference
Cholesterol
Cholesterol, HDL

Reference

1.Toi M., Ohashi Y., Seow A., Moriya T., Tse G., Sasano H, et al. The Breast Cancer Working Group presentation was divided into three sections: the epidemiology, pathology and treatment of breast cancer. Jpn J Clin Oncol. 2010. 40(Suppl 1):i13–8.

2.Ministry of health and welfare. Annual report of the central cancer registry in Korea. Gwacheon: Central Cancer Registry Center, Korea Central Cancer Registry;2009.

3.Agnoli C., Berrino F., Abagnato CA., Muti P., Panico S., Crosignani P, et al. Metabolic syndrome and postmenopausal breast cancer in the ORDET cohort: a nested case-control study. Nutr Metab Cardiovasc Dis. 2010. 20(1):41–8.

4.Muti P., Quattrin T., Grant BJ., Krogh V., Micheli A., Schünemann HJ, et al. Fasting glucose is a risk factor for breast cancer: a prospective study. Cancer epidemiol Biomarkers Prev. 2002. 11(11):1361–8.

5.Furberg AS., Veierød MB., Wilsgaard T., Bernstein L., Thune I. Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. J Natl Cancer Inst. 2004. 96(15):1152–60.

6.Piché ME., Lemieux S., Weisnagel SJ., Corneau L., Nadeau A., Bergeron J. Relation of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and fibrinogen to abdominal adipose tissue, blood pressure, and cholesterol and triglyceride levels in healthy postmenopausal women. Am J Cardiol. 2005. 96(1):92–7.

7.Kabat GC., Kim M., Chlebowski RT., Khandekar J., Ko MG., McTiernan A, et al. A longitudinal study of the metabolic syndrome and risk of postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev. 2009. 18(7):2046–53.

8.Bjørge T., Lukanova A., Jonsson H., Tretli S., Ulmer H., Manjer J, et al. Metabolic syndrome and breast cancer in the me-can (metabolic syndrome and cancer) project. Cancer Epidemiol Biomarkers Prev. 2010. 19(7):1737–45.

9.Boyd NF., Lockwood GA., Martin LJ., Knight JA., Byng JW., Yaffe MJ, et al. Mammographic densities and breast cancer risk. Breast Dis. 1998. 10(3-4):113–26.

10.McCormack VA., dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2006. 15(6):1159–69.

11.Shepherd JA., Kerlikowske K., Ma L., Duewer F., Fan B., Wang J, et al. Volume of mammographic density and risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 2011. 20(7):1473–82.

12.Pawluczyk O., Augustine BJ., Yaffe MJ., Rico D., Yang J., Mawdsley GE, et al. A volumetric method for estimation of breast density on digitized screen-film mammograms. Med Phys. 2003. 30:352–64.

13.Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001. 285(19):2486–97.

14.Lee S., Park HS., Kim SM., Kwon HS., Kim DY., Kim DJ, et al. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. Korean J Obes. 2006. 15(1):1–9.

15.Rice MS., Biessy C., Lajous M., Bertrand KA., Tamimi RM., Torres-Mejía G, et al. Metabolic syndrome and mammographic density in Mexican women. Cancer Prev Res (Phila). 2013. 6(7):701–10.

16.Conroy SM., Butler LM., Harvey D., Gold EB., Sternfeld B., Greendale GA, et al. Metabolic syndrome and mammographic density: the Study of Women's Health Across the Nation. Int J Cancer. 2011. 129(7):1699–707.

17.Boyd NF., Lockwood GA., Byng JW., Little LE., Yaffe MJ., Tritchler DL. The relationship of anthropometric measures to radiological features of the breast in premenopausal women. Br J Cancer. 1998. 78(9):1233–8.

18.Sung J., Song YM., Stone J., Lee K., Kim SY. Association of body size measurements and mammographic density in Korean women: the Healthy Twin study. Cancer Epidemiol Biomarkers Prev. 2010. 19(6):1523–31.

19.Habel LA., Capra AM., Oestreicher N., Greendale GA., Cauley JA., Bromberger J, et al. Mammographic density in a multiethnic cohort. Menopause. 2007. 14(5):891–9.

20.Heng D., Gao F., Jong R., Fishell E., Yaffe M., Martin L, et al. Risk factors for breast cancer associated with mammographic features in Singaporean chinese women. Cancer Epidemiol Biomarkers Prev. 2004. 13(11 Pt 1):1751–8.

21.Stoll BA. Upper abdominal obesity, insulin resistance and breast cancer risk. Int J Obes Relat Metab Disord. 2002. 26(6):747–53.

22.Perks CM., Holly JM. Hormonal mechanisms underlying the relationship between obesity and breast cancer. Endocrinol Metab Cli North Am. 2011. 40(3):485–507. vii.

23.Woolcott CG., Cook LS., Courneya KS., Boyd NF., Yaffe MJ., Terry T, et al. Associations of overall and abdominal adiposity with area and volumetric mammographic measures among postmenopausal women. Int J Cancer. 2011. 129(2):440–8.

24.Boyd NF., Connelly P., Byng J., Yaffe M., Draper H., Little L, et al. Plasma lipids, lipoproteins, and mammographic densities. Cancer Epidemiol Biomarkers Prev. 1995. 4(7):727–33.

25.Furberg AS., Jasienska G., Bjurstam N., Torjesen PA., Emaus A., Lipson SF, et al. Metabolic and hormonal profiles: HDL cholesterol as a plausible biomarker of breast cancer risk. Cancer Epidemiol Biomarkers Prev. 2005. 14(1):33–40.

26.Tamburrini AL., Woolcott CG., Boyd NF., Yaffe MJ., Terry T., Yasui Y, et al. Associations between mammographic density and serum and dietary cholesterol. Breast Cancer Res Treat. 2011. 125(1):181–9.

27.Ferraroni M., Gerber M., Decarli A., Richardson S., Marubini E., Crastes de Paulet P, et al. HDL-cholesterol and breast cancer: a joint study in northern Italy and southern France. Int J Epidemiol. 1993. 22(5):772–80.

28.Cowan LD., O'Connell DL., Criqui MH., Barrett-Connor E., Bush TL., Wallace RB. Cancer mortality and lipid and lipoprotein levels. Lipid Research Clinics Program Mortality Follow-up Study. Am J Epidemiol. 1990. 131(3):468–82.

29.Han C., Zhang HT., Du L., Liu X., Jing J., Zhao X, et al. Serum levels of leptin, insulin, and lipids in relation to breast cancer in China. Endocrine. 2005. 26(1):19–24.

30.Kim Y., Park SK., Han W., Kim DH., Hong YC., Ha EH, et al. Serum high-density lipoprotein cholesterol and breast cancer risk by menopausal status, body mass index, and hormonal receptor in Korea. Cancer Epidemiol Biomarkers Prev. 2009. 18(2):508–15.

31.Gaard M., Tretli S., Urdal P. Risk of breast cancer in relation to blood lipids: a prospective study of 31,209 Norwegian women. Cancer Causes Control. 1994. 5(6):501–9.

32.Gospodarowicz D., Lui GM., Gonzalez R. High-density lipoproteins and the proliferation of human tumor cells maintained on extracellular matrix-coated dishes and exposed to defined medium. Cancer Res. 1982. 42(9):3704–13.

33.Berkowitz JE., Gatewood OM., Goldblum LE., Gayler BW. Hormonal replacement therapy: mammographic manifestations. Radiology. 1990. 174(1):199–201.

34.Granfone A., Campos H., McNamara JR., Schaefer MM., Lamon-Fava S., Ordovas JM, et al. Effects of estrogen replacement on plasma lipoproteins and apolipoproteins in postmenopausal, dyslipidemic women. Metabolism. 1992. 41(11):1193–8.