Impact of BMI on Prevalence of Dense Breasts by Race and Ethnicity
- PMID: 37284771
- PMCID: PMC10701641
- DOI: 10.1158/1055-9965.EPI-23-0049
Impact of BMI on Prevalence of Dense Breasts by Race and Ethnicity
Abstract
Background: Density notification laws require notifying women of dense breasts with dense breast prevalence varying by race/ethnicity. We evaluated whether differences in body mass index (BMI) account for differences in dense breasts prevalence by race/ethnicity.
Methods: Prevalence of dense breasts (heterogeneously or extremely dense) according to Breast Imaging Reporting and Data System and obesity (BMI > 30 kg/m2) were estimated from 2,667,207 mammography examinations among 866,033 women in the Breast Cancer Surveillance Consortium (BCSC) from January 2005 through April 2021. Prevalence ratios (PR) for dense breasts relative to overall prevalence by race/ethnicity were estimated by standardizing race/ethnicity prevalence in the BCSC to the 2020 U.S. population, and adjusting for age, menopausal status, and BMI using logistic regression.
Results: Dense breasts were most prevalent among Asian women (66.0%) followed by non-Hispanic/Latina (NH) White (45.5%), Hispanic/Latina (45.3%), and NH Black (37.0%) women. Obesity was most prevalent in Black women (58.4%) followed by Hispanic/Latina (39.3%), NH White (30.6%), and Asian (8.5%) women. The adjusted prevalence of dense breasts was 19% higher [PR = 1.19; 95% confidence interval (CI), 1.19-1.20] in Asian women, 8% higher (PR = 1.08; 95% CI, 1.07-1.08) in Black women, the same in Hispanic/Latina women (PR = 1.00; 95% CI, 0.99-1.01), and 4% lower (PR = 0.96; 95% CI, 0.96-0.97) in NH White women relative to the overall prevalence.
Conclusions: Clinically important differences in breast density prevalence are present across racial/ethnic groups after accounting for age, menopausal status, and BMI.
Impact: If breast density is the sole criterion used to notify women of dense breasts and discuss supplemental screening it may result in implementing inequitable screening strategies across racial/ethnic groups. See related In the Spotlight, p. 1479.
©2023 American Association for Cancer Research.
Conflict of interest statement
Disclosures and Conflicts of Interest
Diana Miglioretti, PhD, has textbook royalties from Elsevier outside the submitted work. All other authors declare no conflicts of interest.
Figures
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Comment in
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Enhancing Mammography and Empowering Solutions for Breast Cancer Disparities.Cancer Epidemiol Biomarkers Prev. 2023 Nov 1;32(11):1479-1481. doi: 10.1158/1055-9965.EPI-23-0926. Cancer Epidemiol Biomarkers Prev. 2023. PMID: 37908191
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