Quantitative Assessment of Mammographic Breast Density: Relationship with Breast Cancer Risk

Increased mammographic breast density is a moderate independent risk factor for breast cancer, with findings of published studies in which quantitative methods of assessment were used showing a positive association. Breast density may be quantified by using visual assessment or planimetry. Although the category definitions vary, the odds ratio for developing breast cancer for the most dense compared with the least dense breast tissue categories ranges from 1.8 to 6.0, with most studies yielding an odds ratio of 4.0 or greater. Plausible explanations for the association of breast density with increased breast cancer risk may be the development of premalignant lesions such as atypical ductal hyperplasia, elevated growth factors, or increased estrogen production within the breast due to overactive aromatase. The amount of breast density may be due in part to genetic heredity. However, unlike other risk factors, breast density may be influenced. Specifically, breast density is very hormonally responsive and potentially may be influenced by lifestyle factors such as alcohol intake and diet. Assessment of breast density may become useful in risk assessment and prevention decisions.

© RSNA, 2003

References

  • 1 Byrne C. Studying mammographic density: implications for understanding breast cancer. J Natl Cancer Inst 1997; 89:531-533. Crossref, MedlineGoogle Scholar
  • 2 Wolfe JN. Breast patterns as an index of risk for developing breast cancer. AJR Am J Roentgenol 1976; 126:1130-1139. Crossref, MedlineGoogle Scholar
  • 3 Threatt B, Norbeck JM, Ullman NS, et al. Association between mammographic parenchymal pattern classification and incidence of breast cancer. Cancer 1980; 45:2550-2556. Crossref, MedlineGoogle Scholar
  • 4 Witt I, Steen Hansen H, Brunner S. The risk of developing breast cancer in relation to mammography findings. Eur J Radiol 1984; 4:65-67. MedlineGoogle Scholar
  • 5 Egan RL, McSweeney MB. Mammographic parenchymal patterns and risk of breast cancer. Radiology 1979; 133:65-70. LinkGoogle Scholar
  • 6 Moskowitz M, Gartside P, McLaughlin C. Mammographic patterns as markers for high-risk benign breast disease and incident cancers. Radiology 1980; 134:293-295. LinkGoogle Scholar
  • 7 Tabar L, Dean PB. Mammographic parenchymal patterns: risk indicator for breast cancer? JAMA 1982; 247:185-189. Crossref, MedlineGoogle Scholar
  • 8 Carlile T, Thompson DJ, Kopecky KJ, et al. Reproducibility and consistency in classification of breast parenchymal patterns. AJR Am J Roentgenol 1983; 140:1-7. Crossref, MedlineGoogle Scholar
  • 9 Boyd NF, O’Sullivan B, Campbell JE, et al. Mammographic signs as risk factors for breast cancer. Br J Cancer 1982; 45:185-193. Crossref, MedlineGoogle Scholar
  • 10 Boyd NF, Byng JW, Jong RA, et al. Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 1995; 87:670-675. Crossref, MedlineGoogle Scholar
  • 11 Wolfe JN, Saftlas AF, Salane M. Mammographic parenchymal patterns and quantitative evaluation of mammographic densities: a case-control study. AJR Am J Roentgenol 1987; 148:1087-1092. Crossref, MedlineGoogle Scholar
  • 12 Saftlas AF, Hoover RN, Brinton LA, et al. Mammographic densities and risk of breast cancer. Cancer 1991; 67:2833- 2838. Crossref, MedlineGoogle Scholar
  • 13 Kato I, Beinart C, Bleich A, Su S, Kim M, Toniolo PG. A nested case-control study of mammographic patterns, breast volume, and breast cancer. Cancer Causes Control 1995; 6:431-438. Crossref, MedlineGoogle Scholar
  • 14 Brisson J, Merletti F, Sadowsky NL, Twaddle JA, Morrison AS, Cole P. Mammographic features of the breast and breast cancer risk. Am J Epidemiol 1982; 115:428-437. Crossref, MedlineGoogle Scholar
  • 15 Brisson J, Morrison AS, Kopans DB, et al. Height and weight, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 1984; 119:371-381. Crossref, MedlineGoogle Scholar
  • 16 Brisson J, Verreault R, Morrison AS, Tennina S, Meyer F. Diet, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 1989; 130:14-24. Crossref, MedlineGoogle Scholar
  • 17 Byrne C, Schairer C, Wolfe J, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst 1995; 87:1622-1629. Crossref, MedlineGoogle Scholar
  • 18 Lam PB, Vacek PM, Geller BM, Muss HB. The association of increased weight, body mass index, and tissue density with risk of breast carcinoma in Vermont. Cancer 2000; 89:369-375. Crossref, MedlineGoogle Scholar
  • 19 Van Gils CH, Hendricks JH, Holland R, et al. Changes in mammographic breast density and concomitant changes in breast cancer risk. Eur J Cancer Prev 1999; 8:509-515. Crossref, MedlineGoogle Scholar
  • 20 Maskarinec G, Meng L. A case-control study of mammographic densities in Hawaii. Breast Cancer Res Treat 2000; 63:153-161. Crossref, MedlineGoogle Scholar
  • 21 Soderqvist G, Isaksson E, von Schoultz B, Carlstrom K, Tani E, Skoog L. Proliferation of breast epithelial cells in healthy women during the menstrual cycle. Am J Obstet Gynecol 1997; 176:123-128. Crossref, MedlineGoogle Scholar
  • 22 Graham SJ, Stanchev PL, Lloyd-Smith JO, Bronskill MJ, Plewes DB. Changes in fibroglandular volume and water content of breast tissue during the menstrual cycle observed by MR imaging at 1.5 T. J Magn Reson Imaging 1995; 5:695-701. Crossref, MedlineGoogle Scholar
  • 23 Anderson TJ. Pathological studies of apoptosis in the normal breast. Endocr Relat Cancer 1999; 6:9-12. Crossref, MedlineGoogle Scholar
  • 24 White E, Velentagas P, Mandelson MT, et al. Variation in mammographic breast density by time in menstrual cycle among women aged 40–49 years. J Natl Cancer Inst 1998; 90:906-910. Crossref, MedlineGoogle Scholar
  • 25 Ursin G, Parisky YR, Pike MC, Spicer DV. Mammographic density changes during the menstrual cycle. Cancer Epidemiol Biomarkers Prev 2001; 10:141-142. MedlineGoogle Scholar
  • 26 Stomper PC, DSouza DJ, DiNitto PA. Analysis of parenchymal density on mammograms in 1353 women 25–79 years old. AJR Am J Roentgenol 1996; 167:1261-1265. Crossref, MedlineGoogle Scholar
  • 27 Oza AM, Boyd NF. Mammographic parenchymal patterns: a marker of breast cancer risk. Epidemiol Rev 1993; 15:196-208. Crossref, MedlineGoogle Scholar
  • 28 Saftlas AF, Szklo M. Mammographic parenchymal patterns and breast cancer risk. Epidemiol Rev 1987; 9:146-174. Crossref, MedlineGoogle Scholar
  • 29 Vachon CM, King RA, Atwood LD, Kuni CC, Sellers TA. Preliminary sibpair linkage analysis of percent mammographic density. J Natl Cancer Inst 1999; 91:1778-1779. Crossref, MedlineGoogle Scholar
  • 30 Pankow JS, Vachon CM, Kuni CC, et al. Genetic analysis of mammographic breast density in adult women: evidence of a gene effect. J Natl Cancer Inst 1997; 89:549-556. Crossref, MedlineGoogle Scholar
  • 31 Lee-Han H, Cooke G, Boyd NF. Quantitative evaluation of mammographic densities: a comparison of methods of assessment. Eur J Cancer Prev 1995; 4:285-292. Crossref, MedlineGoogle Scholar
  • 32 American College of Radiology. Breast imaging reporting and data system (BI-RADS) Reston, Va: American College of Radiology, 1993. Google Scholar
  • 33 Berg WA, Campassi C, Langenberg P, Sexton MJ. Breast Imaging Reporting and Data System: Inter- and intraobserver variability in feature analysis and final assessment. AJR Am J Roentgenol 2000; 174:1769-1777. Crossref, MedlineGoogle Scholar
  • 34 Kerlikowski K, Grady D, Barclay J, et al. Variability and accuracy in mammographic interpretation using the American College of Radiology Breast Imaging Reporting and Data System. J Natl Cancer Inst 1998; 90:1801-1809. Crossref, MedlineGoogle Scholar
  • 35 Byng JW, Yaffe MJ, Jong RA, et al. Analysis of mammographic density and breast cancer risk for digitized mammograms. RadioGraphics 1998; 18:1587- 1598. LinkGoogle Scholar
  • 36 Freedman M, San Martin J, O’Gorman J, et al. Digitized mammography: a clinical trial of postmenopausal women randomly assigned to receive raloxifene, estrogen, or placebo. J Natl Cancer Inst 2001; 93:51-56. Crossref, MedlineGoogle Scholar
  • 37 Karssemeijer N. Automated classification of parenchymal patterns in mammograms. Phys Med Biol 1998; 43:365-378. Crossref, MedlineGoogle Scholar
  • 38 Sivaramakrishna R, Obuchowski NA, Chilcote WA, Powell KA. Automatic segmentation of mammographic density. Acad Radiol 2001; 8:250-256. Crossref, MedlineGoogle Scholar
  • 39 Zhou C, Chan HP, Petrick N, et al. Computerized image analysis: estimation of breast density on mammograms. Med Phys 2001; 28:1056-1069. Crossref, MedlineGoogle Scholar
  • 40 Chang YH, Wang XH, Hardesty LA, et al. Computerized assessment of tissue composition on digitized mammograms. Acad Radiol 2002; 9:899-905. Crossref, MedlineGoogle Scholar
  • 41 Lee NA, Rusinek H, Weinreb J, et al. Fatty and fibroglandular tissue volumes in the breasts of women 20–83 years old: comparison of x-ray mammography and computer-assisted MR imaging. AJR Am J Roentgenol 1997; 168:501-506. Crossref, MedlineGoogle Scholar
  • 42 Graham SJ, Bronskill MJ, Byng JW, Yaffe MJ, Boyd NF. Quantitative correlation of breast tissue parameters using magnetic resonance and x-ray mammography. Br J Cancer 1996; 73:162-168. Crossref, MedlineGoogle Scholar
  • 43 Blend R, Rideout DF, Kaizer L, Shannon P, Tudor-Roberts B, Boyd NF. Parenchymal patterns of the breast defined by real time ultrasound. Eur J Cancer Prev 1995; 4:293-298. Crossref, MedlineGoogle Scholar
  • 44 Shephard JA, Kerlikowski KM, Smith-Bindman R, Genant HK, Cummings SR. Measurement of breast density with dual x-ray absorptiometry: feasibility. Radiology 2002; 223:554-557. LinkGoogle Scholar
  • 45 Sala E, Warren R, McCann J, Duffy S, Luben R, Day N. Mammographic parenchymal patterns and breast cancer natural history: a case-control study. Acta Oncol 2001; 40:461-465. Crossref, MedlineGoogle Scholar
  • 46 Roubidoux MA, Bailey JE, Wray LA, Helvie MA. Invasive cancers detected after negative breast cancer screening results: relationship of mammographic density to tumor prognostic factors. Radiology 2004; 230:42-48. LinkGoogle Scholar
  • 47 Blane CE, Fitzgerald JT, Gruppen LD, Oh MS, Helvie MA, Andersson I. Decreasing rate of fatty involution at screening mammography. Acad Radiol 2002; 9:895-898. Crossref, MedlineGoogle Scholar
  • 48 Boyd NF, Lockwood GA, Byng JW, Tritchler DL, Yaffe MJ. Mammographic densities and breast cancer risk. Cancer Epidemiol Biomarkers Prev 1998; 7:1133- 1144. MedlineGoogle Scholar
  • 49 Egan RL, Mosteller RC. Breast cancer mammography patterns. Cancer 1977; 40:2087-2090. Crossref, MedlineGoogle Scholar
  • 50 van Gils CH, Otten JD, Verbeek AL, Hendricks JH. Mammographic breast density and risk of breast cancer: masking bias or causality? Eur J Epidemiol 1998; 14:315-320. Crossref, MedlineGoogle Scholar
  • 51 White J. Breast density and cancer risk: what is the relationship? J Natl Cancer Inst 2000; 92:443. Crossref, MedlineGoogle Scholar
  • 52 Cigarette smoking among adults—United States, 2000.MMWR Morb Mortal Wkly Rep2002; 51:642-645. MedlineGoogle Scholar
  • 53 Sala E, Warren R, McCann J, Duffy S, Luben R, Day N. High-risk mammographic parenchymal patterns and anthropometric measures: a case-control study. Br J Cancer 1999; 81:1257-1261. Crossref, MedlineGoogle Scholar
  • 54 Vachon CM, Kuni CC, Anderson K, Anderson VE, Sellers TA. Association of mammographically defined percent breast density with epidemiologic risk factors for breast cancer. Cancer Causes Control 2000; 11:653-662. Crossref, MedlineGoogle Scholar
  • 55 van Gils CH, Hendricks JH, Otten JD, Holland R, Verbeek AL. Parity and mammographic breast density in relation to breast cancer risk: indication of interaction. Eur J Cancer Prev 2000; 9:105-111. Crossref, MedlineGoogle Scholar
  • 56 Boyd NF, Lockwood GA, Martin LJ, et al. Mammographic densities and risk of breast cancer among subjects with a family history of this disease. J Natl Cancer Inst 1999; 91:1404-1408. Crossref, MedlineGoogle Scholar
  • 57 Ziv E, Shepherd J, Smith-Bindman R, Kerlikowske K. Mammographic breast density and family history of breast cancer. J Natl Cancer Inst 2003; 95:556-558. Crossref, MedlineGoogle Scholar
  • 58 Byrne C, Schairer C, Brinton LA, et al. Effects of mammographic density and benign breast disease on breast cancer risk. Cancer Causes Control 2001; 12:103-110. Crossref, MedlineGoogle Scholar
  • 59 Knight JA, Martin LJ, Greenberg CV, et al. Macronutrient intake and change in mammographic breast density at menopause: results from a randomized trial. Cancer Epidemiol Biomarkers Prev 1999; 8:123-128. MedlineGoogle Scholar
  • 60 Vachon CM, Kushi LH, Cerhan JR, Kuni CC, Sellers TA. Association of diet and mammographic breast density in the Minnesota breast cancer family cohort. Cancer Epidemiol Biomarkers Prev 2000; 9:151-160. MedlineGoogle Scholar
  • 61 Boyd NF, Greenberg C, Lockwood G, et al. Effects at 2 years of a low-fat, high-carbohydrate diet on radiologic features of the breast: results from a randomized trial. J Natl Cancer Inst 1997; 89:488-496. Crossref, MedlineGoogle Scholar
  • 62 Jakes RW, Duffy SW, Ng F, et al. Mammographic parenchymal patterns and self-reported soy intake in Singapore Chinese women. Cancer Epidemiol Biomarkers Prev 2002; 11:608-613. MedlineGoogle Scholar
  • 63 Parkin DM, Muir CS. Cancer incidence in five continents: comparability and quality of data. IARC Sci Publ 1992; 120:45-173. MedlineGoogle Scholar
  • 64 Gram IT, Funkhouser E, Tabar L. Moderate physical activity in relation to mammographic patterns. Cancer Epidemiol Biomarkers Prev 1999; 8:117-122. MedlineGoogle Scholar
  • 65 Kaufman Z, Garstin WIH, Hayes R, Michell MJ, Baum M. The mammographic parenchymal patterns of women on hormonal replacement therapy. Clin Radiol 1991; 43:389-392. Crossref, MedlineGoogle Scholar
  • 66 Sterns EE, Zee B. Mammographic density changes in perimenopausal women: is the effect of hormone replacement therapy predictable? Breast Cancer Res Treat 2000; 59:125-132. Crossref, MedlineGoogle Scholar
  • 67 Rutter CM, Mandelson MT, Laya MB, Taplin S. Changes in breast density associated with initiation, discontinuation, and continuing use of hormone replacement therapy. JAMA 2001; 285:171-176. Crossref, MedlineGoogle Scholar
  • 68 McNicholas MM, Heneghan JP, Milner MH, Tunney T, Hourihane JB, MacErlaine DP. Pain and increased mammographic density in women receiving hormone replacement therapy: a prospective study. AJR Am J Roentgenol 1994; 163:311-315. Crossref, MedlineGoogle Scholar
  • 69 Stomper PC, Van Voorhis BJ, Ravnikar VA, Meyer JE. Mammographic changes associated with postmenopausal hormone replacement therapy: a longitudinal study. Radiology 1990; 174:487- 490. LinkGoogle Scholar
  • 70 Berkowitz JE, Gatewood OM, Goldblum LE, Gayler BW. Hormonal replacement therapy: mammographic manifestations. Radiology 1990; 174:199-201. LinkGoogle Scholar
  • 71 Persson I, Thurfjell E, Holmberg L. Effect of estrogen and estrogen-progestin replacement regimens on mammographic breast parenchymal density. J Clin Oncol 1997; 15:3201-3207. Crossref, MedlineGoogle Scholar
  • 72 Laya MB, Gallagher JC, Schreiman JS, Larson EB, Watson P, Weinstein L. Effect of postmenopausal hormonal replacement therapy on mammographic density and parenchymal pattern. Radiology 1995; 196:433-437. LinkGoogle Scholar
  • 73 Greendale GA, Reboussin BA, Sie A, et al. Effects of estrogen and estrogen-progestin on mammographic parenchymal density. Ann Intern Med 1999; 130:262-269. Crossref, MedlineGoogle Scholar
  • 74 Sendag F, Cosan Terek M, Ozsener S, et al. Mammographic density changes during different postmenopausal hormone replacement therapies. Fertil Steril 2001; 76:445-450. Crossref, MedlineGoogle Scholar
  • 75 Lundstrom E, Wilczek B, von Palffy Z, Soderqvist G, von Schoultz B. Mammographic breast density during hormone replacement therapy: differences according to treatment. Am J Obstet Gynecol 1999; 181:348-352. Crossref, MedlineGoogle Scholar
  • 76 Harvey JA, Pinkerton JV, Herman CR. Short-term cessation of hormone replacement therapy and improvement of mammographic specificity. J Natl Cancer Inst 1997; 89:1623-1625. Crossref, MedlineGoogle Scholar
  • 77 Colacurci N, Fornaro F, DeFranciscis P, Mele D, Palermo M, delVecchio W. Effects of a short-term suspension of hormone replacement therapy on mammographic density. Fertil Steril 2001; 76:451-455. Crossref, MedlineGoogle Scholar
  • 78 Schairer C, Lubin J, Troisi R, Sturgeon S, Brinton L, Hoover R. Menopausal estrogen and estrogen-progestin replacement therapy and breast cancer risk. JAMA 2000; 283:485-491. Crossref, MedlineGoogle Scholar
  • 79 Persson I, Weiderpass E, Bergkvist L, et al. Risks of breast and endometrial cancer after estrogen and estrogen-progestin replacement. Cancer Causes Control 1999; 10:253-260. Crossref, MedlineGoogle Scholar
  • 80 Ross RK, Paganini-Hill A, Wan PC, Pike MC. Effect of hormone replacement therapy on breast cancer risk: estrogen versus estrogen plus progestin. J Natl Cancer Inst 2000; 92:328-332. Crossref, MedlineGoogle Scholar
  • 81 Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002; 288:321-333. Crossref, MedlineGoogle Scholar
  • 82 Hofseth LJ, Raafat AM, Osuch JR, Pathak DR, Slomski CA, Haslam SZ. Hormone replacement therapy with estrogen or estrogen plus medroxyprogesterone acetate is associated with increased epithelial proliferation in the normal postmenopausal breast. J Clin Endocrinol Metab 1999; 84:4559-4565. MedlineGoogle Scholar
  • 83 Brisson J, Brisson B, Cote G, Maunsell E, Berube S, Robert J. Tamoxifen and mammographic breast densities. Cancer Epidemiol Biomarkers Prev 2000; 9:911- 915. MedlineGoogle Scholar
  • 84 Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998; 90:1371-1388. Crossref, MedlineGoogle Scholar
  • 85 Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. JAMA 1999; 281:2189-2197. Crossref, MedlineGoogle Scholar
  • 86 Cummings SR, Duong T, Kenyon E, Cauley JA, Whitehead M, Krueger KA. Serum estradiol level and risk of breast cancer during treatment with raloxifene. JAMA 2002; 287:216-220. Crossref, MedlineGoogle Scholar
  • 87 Spicer DV, Ursin G, Parisky YR, et al. Changes in mammographic densities induced by a hormonal contraceptive designed to reduce breast cancer risk. J Natl Cancer Inst 1994; 86:431-436. Crossref, MedlineGoogle Scholar
  • 88 van de Ven J, Donker GH, Sprong M, Blankenstein MA, Thijssen JH. Effect of tibolone (Org OD14) and its metabolites on aromatase and estrone sulfatase activity in human breast adipose stromal cells and in MCF-7 and T47D breast cancer cells. J Steroid Biochem Mol Biol 2002; 81:237-247. Crossref, MedlineGoogle Scholar
  • 89 Lundstrom E, Christow A, Kersemaekers W, et al. Effects of tibolone and continuous combined hormone replacement therapy on mammographic breast density. Am J Obstet Gynecol 2002; 186:717-722. Crossref, MedlineGoogle Scholar
  • 90 Page DL, Winfield AC. The dense mammogram. AJR Am J Roentgenol 1986; 147:487-489. Crossref, MedlineGoogle Scholar
  • 91 Boyd NF, Jensen HM, Cooke G, Lee Han H. Relationship between mammographic and histologic risk factors for breast cancer. J Natl Cancer Inst 1992; 84:1170-1179. Crossref, MedlineGoogle Scholar
  • 92 Guo YP, Martin LJ, Hanna W, et al. Growth factors and stromal matrix proteins associated with mammographic densities. Cancer Epidemiol Biomarkers Prev 2001; 10:243-248. MedlineGoogle Scholar
  • 93 Bright R, Morrison A, Brisson J, et al. Relationship between mammographic and histologic features of breast tissue in women with benign biopsies. Cancer 1988; 61:266-271. Crossref, MedlineGoogle Scholar
  • 94 Arthur JE, Ellis IO, Flowers C, Roebuck E, Elston CW, Blamey RW. The relationship of “high risk” mammographic patterns to histological risk factors for development of cancer in the human breast. Br J Radiol 1990; 63:845-849. Crossref, MedlineGoogle Scholar
  • 95 Urbanski S, Jensen HM, Cooke G, et al. The association of histological and radiological indicators of breast cancer risk. Br J Cancer 1988; 58:474-479. Crossref, MedlineGoogle Scholar
  • 96 Lee MM, Petrakis NL, Wrensch MR, King EB, Miike R, Sickles E. Association of abnormal nipple aspirate cytology and mammographic breast pattern and density. Cancer Epidemiol Biomarkers Prev 1994; 3:33-36. MedlineGoogle Scholar
  • 97 Byrne C, Colditz GA, Willett WC, Speizer FE, Pollak M, Hankinson SE. Plasma insulin-like growth factor (IGF) I, IGF-binding protein 3, and mammographic density. Cancer Res 2000; 60:3744-3748. MedlineGoogle Scholar
  • 98 Boyd NF, Stone J, Martin LJ, et al. The association of breast mitogens with mammographic densities. Br J Cancer 2002; 87:876-882. Crossref, MedlineGoogle Scholar
  • 99 Jefcoate CR, Liehr JG, Santen RJ, et al. Tissue-specific synthesis and oxidative metabolism of estrogens. J Natl Cancer Inst Monogr 2000; 27:95-112. MedlineGoogle Scholar
  • 100 Pasqualini JR, Chetrite G, Blacker C, et al. Concentrations of estrone, estradiol, and estrone sulfate and evaluation of sulfatase and aromatase activities in pre- and post menopausal breast cancer patients. J Clin Endocrinol Metab 1996; 81:1460-1464. MedlineGoogle Scholar
  • 101 Yue W, Santen RJ, Wang JP, Hamilton CJ, Demers LM. Aromatase within the breast. Endocr Relat Cancer 1999; 6:157-164. Crossref, MedlineGoogle Scholar
  • 102 Hankinson SE, Willett WC, Michaud DS, et al. Plasma prolactin levels and subsequent risk of breast cancer in postmenopausal women. J Natl Cancer Inst 1999; 91:629-634. Crossref, MedlineGoogle Scholar
  • 103 Boyd NF, Dite GS, Stone J, et al. Heritability of mammographic density, a risk factor for breast cancer. N Engl J Med 2002; 347:886-894. Crossref, MedlineGoogle Scholar
  • 104 Huo Z, Giger ML, Olopade OI, et al. Computerized analysis of digitized mammograms of BRCA1 and BRCA2 gene mutation carriers. Radiology 2002; 225:519-526. LinkGoogle Scholar
  • 105 Boyd NF, Fishell E, Jong R, et al. Mammographic densities as a criterion for entry to a clinical trial of breast cancer prevention. Br J Cancer 1995; 72:476- 479. Crossref, MedlineGoogle Scholar

Article History

Published in print: Jan 2004