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Breast Neoplasms: HELP
Articles by Lusine Yaghjyan
Based on 16 articles published since 2009
(Why 16 articles?)
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Between 2009 and 2019, L. Yaghjyan wrote the following 16 articles about Breast Neoplasms.
 
+ Citations + Abstracts
1 Review Physical activity and mammographic breast density: a systematic review. 2012

Yaghjyan, Lusine / Colditz, Graham A / Wolin, Kathleen. ·Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO 63110, USA, yaghjyanl@wudosis.wustl.edu ·Breast Cancer Res Treat · Pubmed #22814722.

ABSTRACT: Studies show a protective relationship between physical activity and breast cancer risk across the life course from menarche to postmenopausal years. Mammographic breast density is a known and strong breast cancer risk factor. Whether the association of physical activity with breast cancer risk is mediated through mammographic breast density is poorly understood. This systematic review summarizes published studies that investigated the association between physical activity and mammographic breast density and discusses the methodological issues that need to be addressed. We included in this review studies that were published before October 31, 2011 that were accessible in full-text format and were published in English. We identified 20 studies through the PubMed Central, BioMed Central, Embase, and Scopus and using the search terms "physical activity and breast density" and "exercise and breast density" as well as through manual searches of the bibliographies of the articles identified in electronic searches. We found no evidence of association between physical activity and breast density across the studies by grouping them first by the timing of physical activity assessment (in adolescence, current/recent, past, and lifetime) and then by women's menopausal status (premenopausal and postmenopausal). Given the strength of the relationship between physical activity and breast cancer and the null findings of this review, it is unlikely that the effect of physical activity is mediated through an effect on breast density.

2 Review Vitamin D and mammographic breast density: a systematic review. 2012

Yaghjyan, Lusine / Colditz, Graham A / Drake, Bettina. ·Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University in St Louis, Campus Box 8100, 660 S Euclid Avenue, St Louis, MO 63110, USA. yaghjyanl@wudosis.wustl.edu ·Cancer Causes Control · Pubmed #21984232.

ABSTRACT: Studies suggest a protective relationship between Vitamin D and breast cancer risk. Several studies assessed the association of Vitamin D with mammographic breast density, a known and strong breast cancer risk factor. Understanding the potential role of Vitamin D in the modification of breast density might open new avenues in breast cancer prevention. This systematic review summarizes published studies that investigated the association between Vitamin D and mammographic breast density and offers suggestions for strategies to advance our scientific knowledge.

3 Review Estrogens in the breast tissue: a systematic review. 2011

Yaghjyan, Lusine / Colditz, Graham A. ·Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, Campus Box 8100, 660 S. Euclid Avenue, St. Louis, MO 63110, USA. yaghjyanl@wudosis.wustl.edu ·Cancer Causes Control · Pubmed #21286801.

ABSTRACT: The role of estrogens in breast carcinogenesis has been investigated at the level of whole body (plasma) and cell (molecular, receptors, etc.). Growing attention focused on the breast tissue being an intracrine organ, with potentially important local estrogen production in the breast. However, very little is known about the local breast tissue estrogen levels. Understanding the role of the tissue estrogens in breast carcinogenesis might open new avenues in breast cancer prevention. This systematic review summarizes published studies that measured local estrogen levels in the breast and offers suggestions for strategies to fill gaps in our existing scientific knowledge.

4 Article Interactions of coffee consumption and postmenopausal hormone use in relation to breast cancer risk in UK Biobank. 2018

Yaghjyan, Lusine / Rich, Shannan / Mao, Liang / Mai, Volker / Egan, Kathleen M. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA. lyaghjyan@ufl.edu. · Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA. · Department of Geography, College of Liberal Arts and Sciences, University of Florida, 330 Newell Dr, Gainesville, FL, 32603, USA. · Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA. ·Cancer Causes Control · Pubmed #29651651.

ABSTRACT: PURPOSE: We investigated the association of coffee consumption with postmenopausal breast cancer risk, overall and by the status of postmenopausal hormone therapy (PMH). METHODS: This study included 126,182 postmenopausal women (2,636 with breast cancer and 123,546 without) from UK Biobank. Cancer diagnoses were ascertained through the linkage to the UK National Health Service Central Registers. Information on breast cancer risk factors and coffee consumption was collected at baseline and updated during follow-up. We used Cox proportional hazards regression to evaluate associations between coffee consumption and breast cancer, overall and in stratified analyses by woman's PMH status (none, past, current). RESULTS: In the overall analysis, coffee consumption was not associated with breast cancer risk (Hazard Ratio [HR] 1.00, 95% CI 0.91-1.11 for 2-3 cups/day, and HR 0.98, 95% CI 0.87-1.10 for ≥ 4 cups/day, p-trend = 0.69). Women with no PMH history who consumed ≥ 4 cups/day had a 16% reduced risk of breast cancer as compared to women who consumed < 7 cups/week (HR 0.84, 95% CI 0.71-1.00). Among women with past PMH, those consuming ≥ 4 cups/day had a 22% greater risk of breast cancer than women consuming < 7 cups/week (HR 1.22, 95% CI 1.01-1.47). No association was found among current PMH users. We found no significant interaction between PMH and coffee consumption (p = 0.24). CONCLUSIONS: Coffee consumption might be associated with increased breast cancer risk in women who used hormones in the past. Further studies are warranted to confirm these findings and elucidate potential biological mechanisms underlying the observed associations.

5 Article Associations of coffee consumption and caffeine intake with mammographic breast density. 2018

Yaghjyan, Lusine / Colditz, Graham / Rosner, Bernard / Gasparova, Aleksandra / Tamimi, Rulla M. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainessville, FL, 32610, USA. lyaghjyan@ufl.edu. · Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA. · Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA. · Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. · Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainessville, FL, 32610, USA. ·Breast Cancer Res Treat · Pubmed #29340883.

ABSTRACT: PURPOSE: Previous studies suggest that coffee and caffeine intake may be associated with reduced breast cancer risk. We investigated the association of coffee and caffeine intake with mammographic breast density by woman's menopausal status and, in postmenopausal women, by hormone therapy (HT). METHODS: This study included 4130 cancer-free women within the Nurses' Health Study and Nurses' Health Study II cohorts. Percent breast density (PD) was measured from digitized film mammograms using a computer-assisted thresholding technique and square root-transformed for the analysis. Average cumulative coffee/caffeine consumption was calculated using data from all food frequency questionnaires preceding the mammogram date. Information regarding breast cancer risk factors was obtained from questionnaires closest to the mammogram date. We used generalized linear regression to quantify associations of regular, decaffeinated, and total coffee, and energy-adjusted caffeine intake with percent density. RESULTS: In multivariable analyses, decaffeinated coffee was positively associated with PD in premenopausal women (2+ cups/day: β = 0.23, p trend = 0.03). In postmenopausal women, decaffeinated and total coffee were inversely associated with PD (decaffeinated 2+ cups/day: β = - 0.24, p trend = 0.04; total 4+ cups/day: β = - 0.16, p trend = 0.02). Interaction of decaffeinated coffee with menopausal status was significant (p-interaction < 0.001). Among current HT users, regular coffee and caffeine were inversely associated with PD (regular coffee 4+ cups/day: β = - 0.29, p trend = 0.01; caffeine 4th vs. 1st quartile: β = - 0.32, p trend = 0.01). Among past users, decaffeinated coffee was inversely associated with PD (2+ cups/day β = - 0.70, p trend = 0.02). CONCLUSIONS: Associations of decaffeinated coffee with percent density differ by woman's menopausal status. Associations of regular coffee and caffeine with percent density may differ by HT status.

6 Article Tissue-based associations of mammographic breast density with breast stem cell markers. 2017

Yaghjyan, Lusine / Stoll, Ethan / Ghosh, Karthik / Scott, Christopher G / Jensen, Matthew R / Brandt, Kathleen R / Visscher, Daniel / Vachon, Celine M. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA. lyaghjyan@ufl.edu. · Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA. · Division of General Internal Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN, 55902, USA. · Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA. · Department of Radiology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA. · Department of Anatomic Pathology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA. · Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA. ·Breast Cancer Res · Pubmed #28851411.

ABSTRACT: BACKGROUND: Mammographic breast density is a well-established, strong breast cancer risk factor but the biology underlying this association remains unclear. Breast density may reflect underlying alterations in the size and activity of the breast stem cell pool. We examined, for the first time, associations of CD44, CD24, and aldehyde dehydrogenase family 1 member A1 (ALDH1A1) breast stem cell markers with breast density. METHODS: We included in this study 64 asymptomatic healthy women who previously volunteered for a unique biopsy study of normal breast tissue at the Mayo Clinic (2006-2008). Mammographically identified dense and non-dense areas were confirmed/localized by ultrasound and biopsied. Immunohistochemical analysis of the markers was performed according to a standard protocol and the staining was assessed by a single blinded pathologist. In core biopsy samples retrieved from areas of high vs. low density within the same woman, we compared staining extent and an expression score (the product of staining intensity and extent), using the signed rank test. All tests of statistical significance were two-sided. RESULTS: A total of 64, 28, and 10 women were available for CD44, CD24, and ALDH1A1 staining, respectively. For all three markers, we found higher levels of staining extent in dense as compared to non-dense tissue, though for CD24 and ALDH1A1 the difference did not reach statistical significance (CD44, 6.3% vs. 2.0%, p < 0.001; CD24, 8.0% vs. 5.6%, p = 0.10; and ALDH1A1, 0.5% vs. 0.3%, p = 0.12). The expression score for CD44 was significantly greater in dense as compared to non-dense tissue (9.8 vs.3.0, p < 0.001). CONCLUSIONS: Our findings suggest an increased presence and/or activity of stem cells in dense as compared to non-dense breast tissue.

7 Article Interaction of mammographic breast density with menopausal status and postmenopausal hormone use in relation to the risk of aggressive breast cancer subtypes. 2017

Yaghjyan, Lusine / Tamimi, Rulla M / Bertrand, Kimberly A / Scott, Christopher G / Jensen, Matthew R / Pankratz, V Shane / Brandt, Kathy / Visscher, Daniel / Norman, Aaron / Couch, Fergus / Shepherd, John / Fan, Bo / Chen, Yunn-Yi / Ma, Lin / Beck, Andrew H / Cummings, Steven R / Kerlikowske, Karla / Vachon, Celine M. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA. lyaghjyan@ufl.edu. · Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA. · Department of Epidemiology, Harvard T.H Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA. · Slone Epidemiology Center at Boston University, Boston, MA, USA. · Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. · Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA. · Department of Anatomic Pathology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. · Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. · Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. · Department of Radiology, University of California, 1 Irving Street, AC109, San Francisco, CA, 94143, USA. · Department of Pathology, University of California, 505 Parnassus AvenueRoom M559, Box 0102, San Francisco, CA, 94143, USA. · Department of Medicine, University of California, 1635 Divisadero St. Suite 600, Box 1793, San Francisco, CA, USA. · Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA. · San Francisco Coordinating Center, California Pacific Medical Center Research Institute, 475 Brannan Street, Suite 220, San Francisco, CA, 94107, USA. · Departments of Medicine and Epidemiology and Biostatistics, University of California, 4150 Clement Street, Mailing Code 111A1, San Francisco, CA, 94121, USA. · General Internal Medicine Section, Department of Veterans Affairs, University of California, 4150 Clement Street, Mailing Code 111A1, San Francisco, CA, 94121, USA. ·Breast Cancer Res Treat · Pubmed #28624977.

ABSTRACT: PURPOSE: We examined the associations of mammographic breast density with breast cancer risk by tumor aggressiveness and by menopausal status and current postmenopausal hormone therapy. METHODS: This study included 2596 invasive breast cancer cases and 4059 controls selected from participants of four nested case-control studies within four established cohorts: the Mayo Mammography Health Study, the Nurses' Health Study, Nurses' Health Study II, and San Francisco Mammography Registry. Percent breast density (PD), absolute dense (DA), and non-dense areas (NDA) were assessed from digitized film-screen mammograms using a computer-assisted threshold technique and standardized across studies. We used polytomous logistic regression to quantify the associations of breast density with breast cancer risk by tumor aggressiveness (defined as presence of at least two of the following tumor characteristics: size ≥2 cm, grade 2/3, ER-negative status, or positive nodes), stratified by menopausal status and current hormone therapy. RESULTS: Overall, the positive association of PD and borderline inverse association of NDA with breast cancer risk was stronger in aggressive vs. non-aggressive tumors (≥51 vs. 11-25% OR 2.50, 95% CI 1.94-3.22 vs. OR 2.03, 95% CI 1.70-2.43, p-heterogeneity = 0.03; NDA 4th vs. 2nd quartile OR 0.54, 95% CI 0.41-0.70 vs. OR 0.71, 95% CI 0.59-0.85, p-heterogeneity = 0.07). However, there were no differences in the association of DA with breast cancer by aggressive status. In the stratified analysis, there was also evidence of a stronger association of PD and NDA with aggressive tumors among postmenopausal women and, in particular, current estrogen+progesterone users (≥51 vs. 11-25% OR 3.24, 95% CI 1.75-6.00 vs. OR 1.93, 95% CI 1.25-2.98, p-heterogeneity = 0.01; NDA 4th vs. 2nd quartile OR 0.43, 95% CI 0.21-0.85 vs. OR 0.56, 95% CI 0.35-0.89, p-heterogeneity = 0.01), even though the interaction was not significant. CONCLUSION: Our findings suggest that associations of mammographic density with breast cancer risk differ by tumor aggressiveness. While there was no strong evidence that these associations differed by menopausal status or hormone therapy, they did appear more prominent among current estrogen+progesterone users.

8 Article Association between air pollution and mammographic breast density in the Breast Cancer Surveilance Consortium. 2017

Yaghjyan, Lusine / Arao, Robert / Brokamp, Cole / O'Meara, Ellen S / Sprague, Brian L / Ghita, Gabriela / Ryan, Patrick. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA. lyaghjyan@ufl.edu. · Group Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA. · Department of Environmental Health, University of Cincinnati, 3223 Eden Ave, Cincinnati, OH, 45267, USA. · Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. · Department of Surgery, University of Vermont, 111 Colchester Avenue, Burlington, VT, 05401, USA. · Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA. ·Breast Cancer Res · Pubmed #28381271.

ABSTRACT: BACKGROUND: Mammographic breast density is a well-established strong risk factor for breast cancer. The environmental contributors to geographic variation in breast density in urban and rural areas are poorly understood. We examined the association between breast density and exposure to ambient air pollutants (particulate matter <2.5 μm in diameter (PM METHODS: Participants included women undergoing mammography screening at imaging facilities within the Breast Cancer Surveillance Consortium (2001-2009). We included women aged ≥40 years with known residential zip codes before the index mammogram (n = 279,967). Breast density was assessed using the American College of Radiology's Breast Imaging-Reporting and Data System (BI-RADS) four-category breast density classification. PM RESULTS: Women with extremely dense breasts had higher mean PM CONCLUSION: Exposure to PM

9 Article Adolescent fiber intake and mammographic breast density in premenopausal women. 2016

Yaghjyan, Lusine / Ghita, Gabriela L / Rosner, Bernard / Farvid, Maryam / Bertrand, Kimberly A / Tamimi, Rulla M. ·Department of Epidemiology, University of Florida, College of Public Health and Health Professions and College of Medicine, 2004 Mowry Rd., Gainesville, 32610, FL, USA. lyaghjyan@ufl.edu. · Department of Biostatistics, University of Florida, College of Public Health and Health Professions and College of Medicine, Gainesville, FL, USA. · Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. · Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. · Harvard/Massachusetts General Hospital Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA. · Slone Epidemiology Center at Boston University, Boston, MA, USA. ·Breast Cancer Res · Pubmed #27520794.

ABSTRACT: BACKGROUND: To date, there is limited and inconsistent epidemiologic evidence for associations of adolescent diet with mammographic breast density, a strong and consistent predictor of breast cancer. We investigated the association of adolescent fiber intake with mammographic density in premenopausal women. METHODS: This study included 743 cancer-free premenopausal women (mean age, 44.9 years) within the Nurses' Health Study II cohort. Percent breast density, absolute dense and non-dense areas were measured from digitized film mammograms using a computer-assisted thresholding technique. Adolescent and adult diet were assessed with a food frequency questionnaire; energy-adjusted nutrient intakes were estimated for each food item. Information regarding breast cancer risk factors was obtained from baseline or biennial questionnaires closest to the mammogram date. We used generalized linear regression to quantify associations between quartiles of adolescent fiber intake and each of the breast density measures, adjusted for potential confounders. Associations were examined separately for total fiber intake; fiber from fruits, vegetables, legumes, and cereal; and food sources of fiber (fruits, vegetables, and nuts). RESULTS: In multivariable analyses, total fiber intake during adolescence was not associated with percent breast density (p for trend = 0.64), absolute dense area (p for trend = 0.80), or non-dense area (p for trend = 0.75). Similarly, neither consumption of fiber from fruits, vegetables, legumes, or cereal nor specific sources of fiber intake (fruits, vegetables, or nuts) during adolescence were associated with any of the mammographic density phenotypes. CONCLUSIONS: Our findings do not support the hypothesis that adolescent fiber intake is associated with premenopausal mammographic breast density.

10 Article Postmenopausal mammographic breast density and subsequent breast cancer risk according to selected tissue markers. 2015

Yaghjyan, Lusine / Pettersson, Andreas / Colditz, Graham A / Collins, Laura C / Schnitt, Stuart J / Beck, Andrew H / Rosner, Bernard / Vachon, Celine / Tamimi, Rulla M. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA. · Department of Epidemiology, Harvard School of Public Health, 181 Longwood Avenue, Boston, MA 02115, USA. · Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, 171 76 Solna, Stockholm, Sweden. · Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, 660S. Euclid Avenue, St Louis, MO 63110, USA. · Institute for Public Health, Washington University in St Louis, St Louis, MO, USA. · Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA. · Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA. · Department of Health Sciences Research, Mayo Clinic College of Medicine, Charlton 6-239, 200 First Street Southwest, Rochester, MN 55905, USA. ·Br J Cancer · Pubmed #26335607.

ABSTRACT: BACKGROUND: This study aimed to determine if associations of pre-diagnostic percent breast density, absolute dense area, and non-dense area with subsequent breast cancer risk differ by the tumour's molecular marker status. METHODS: We included 1010 postmenopausal women with breast cancer and 2077 matched controls from the Nurses' Health Study (NHS) and the Nurses' Health Study II (NHS II) cohorts. Breast density was estimated from digitised film mammograms using computer-assisted thresholding techniques. Information on breast cancer risk factors was obtained prospectively from biennial questionnaires. Polychotomous logistic regression was used to assess associations of breast density measures with tumour subtypes by the status of selected tissue markers. All tests of statistical significance were two sided. RESULTS: The association of percent density with breast cancer risk appeared to be stronger in ER- as compared with ER+ tumours, but the difference did not reach statistical significance (density ⩾50% vs <10% odds ratio (OR)=3.06, 95% confidence interval (CI) 2.17-4.32 for ER+; OR=4.61, 95% CI 2.36-9.03 for ER-, Pheterogeneity=0.08). Stronger positive associations were found for absolute dense area and CK5/6- and EGFR- as compared with respective marker-positive tumours (Pheterogeneity=0.002 and 0.001, respectively). Stronger inverse associations of non-dense area with breast cancer risk were found for ER- as compared with ER+ tumours (Pheterogeneity=0.0001) and for AR+, CK5/6+, and EGFR+ as compared with respective marker-negative tumours (Pheterogeneity=0.03, 0.005, and 0.009, respectively). The associations of density measures with breast cancer did not differ by progesterone receptor and human epidermal growth factor receptor 2 status. CONCLUSIONS: Breast density influences the risk of breast cancer subtypes by potentially different mechanisms.

11 Article Mammographic breast density and breast cancer risk: interactions of percent density, absolute dense, and non-dense areas with breast cancer risk factors. 2015

Yaghjyan, Lusine / Colditz, Graham A / Rosner, Bernard / Tamimi, Rulla M. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA. ·Breast Cancer Res Treat · Pubmed #25677739.

ABSTRACT: We investigated if associations of breast density and breast cancer differ according to the level of other known breast cancer risk factors, including body mass index (BMI), age at menarche, parity, age at first child's birth, age at menopause, alcohol consumption, a family history of breast cancer, a history of benign breast disease, and physical activity. This study included 1,044 postmenopausal incident breast cancer cases diagnosed within the Nurses' Health Study cohort and 1,794 matched controls. Percent breast density, absolute dense, and non-dense areas were measured from digitized film images with computerized techniques. Information on breast cancer risk factors was obtained prospectively from biennial questionnaires. Percent breast density was more strongly associated with breast cancer risk in current postmenopausal hormone users (≥50 vs. 10 %: OR 5.34, 95 % CI 3.36-8.49) as compared to women with past (OR 2.69, 95 % CI 1.32-5.49) or no hormone history (OR 2.57, 95 % CI 1.18-5.60, p-interaction = 0.03). Non-dense area was inversely associated with breast cancer risk in parous women, but not in women without children (p-interaction = 0.03). Associations of density with breast cancer risk did not differ by the levels of BMI, age at menarche, parity, age at first child's birth, age at menopause, alcohol consumption, a family history of breast cancer, a history of benign breast disease, and physical activity. Women with dense breasts, who currently use menopausal hormone therapy are at a particularly high risk of breast cancer. Most breast cancer risk factors do not modify the association between mammographic breast density and breast cancer risk.

12 Article Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005. 2014

Yaghjyan, Lusine / Wolin, Kathleen / Chang, Su-Hsin / Colditz, Graham. ·Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA, lyaghjyan@ufl.edu. ·Cancer Causes Control · Pubmed #24634091.

ABSTRACT: PURPOSE: We investigated racial disparities in healthy behaviors and cancer screening in a large sample from the US population. METHODS: This analysis used the data from 2005 National Health Interview Survey and included women at age ≥ 40 years who completed the cancer questionnaires (2,427,075 breast cancer survivors and 57,978,043 women without cancer). Self-reported information on cancer history, healthy behaviors (body mass index, smoking, alcohol use, physical activity, fruit/vegetable consumption, sunscreen use) was collected. We compared distributions of each factor among Caucasian, African American, and Hispanic women with and without breast cancer history. RESULTS: Caucasian breast cancer survivors as compared to their cancer-free counterparts were less likely to be current smokers (8.3 vs. 16.9 %, p < 0.001) and to have regular mammograms (51.5 vs. 36.9 %, p < 0.05). Differences in associations between cancer survivors and respondents without cancer among African American and Hispanic women did not reach statistical significance. CONCLUSIONS: Certain breast cancer survivor groups can benefit from tailored preventive services that would address concerns related to selected healthy behaviors and screening practices. However, most of the differences are suggestive and do not differ by race.

13 Article Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to the time since the mammogram. 2013

Yaghjyan, Lusine / Colditz, Graham A / Rosner, Bernard / Tamimi, Rulla M. ·Department of Surgery; Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA. ·Cancer Epidemiol Biomarkers Prev · Pubmed #23603205.

ABSTRACT: BACKGROUND: Few studies have shown that the association between mammographic breast density and breast cancer persists for up to 10 years after the mammogram. We investigated associations of percent density, absolute dense, and nondense areas with breast cancer risk according to the time since the mammogram. METHODS: This study included 1,028 incident breast cancer cases diagnosed within the Nurses' Health Study and 1,780 matched controls. Breast density was measured from digitized film images with computerized techniques. Information on breast cancer risk factors was obtained prospectively from the biennial questionnaires before the date of cancer diagnosis for cases and their matched controls. The data were analyzed with logistic regression. RESULTS: Breast cancer risk increased with increasing percent density and increasing absolute dense area and decreased with increasing nondense area. In multivariate analysis, the magnitude of the association between percent density and breast cancer was similar when the time since the mammogram was <2, 2 to <5, and 5 to <10 years [density ≥50% vs.<10%: ORs, 3.12; 95% confidence interval (CI): 1.55-6.25, 5.35 (95% CI: 2.93-9.76), and 3.91 (95%CI: 2.22-6.88), respectively]. Similarly, the magnitude of association between quartiles of dense and nondense areas and breast cancer risk were similar across the time strata. We found no interactions between the time since the mammogram and breast density measures (Pinteraction > 0.05). CONCLUSIONS: Patterns of the associations between percent density, absolute dense, and nondense area with breast cancer risk persist for up to 10 years after the mammogram. IMPACT: A one-time density measure can be used for long-term breast cancer risk prediction.

14 Article Mammographic breast density and breast cancer risk by menopausal status, postmenopausal hormone use and a family history of breast cancer. 2012

Yaghjyan, Lusine / Colditz, Graham A / Rosner, Bernard / Tamimi, Rulla M. ·Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA. ·Cancer Causes Control · Pubmed #22438073.

ABSTRACT: PURPOSE: Few studies have investigated the association between breast density and breast cancer by a family history of breast cancer, menopausal status, and postmenopausal hormone use (PMH). We investigated if associations of breast density and breast cancer differ according to the status of these risk factors. METHODS: This study included 1,481 incident breast cancer cases diagnosed within the Nurses' Health Study I and II cohorts and 2,779 matched controls. Breast density was measured from digitized film images with computerized techniques. Information on breast cancer risk factors was obtained prospectively from the biennial questionnaires before the date of the cancer diagnosis for cancer cases and their matched controls. The data were analyzed with logistic regression. RESULTS: Breast cancer risk increased with increasing percent breast density in all strata (p for trend in all subsets <0.0001). The density-related risk of breast cancer was similar in women with and without a family history (OR = 4.00 [95 % CI 2.01-7.94] vs. 3.71 [95 % CI 2.79-4.94] for density ≥50 % vs. <10 %, p for interaction = 0.53). The magnitude of the association between density and breast cancer risk, however, appeared to be stronger in premenopausal women than in postmenopausal women without PMH history (OR = 5.49 [95 % CI 2.44-12.39] vs. 3.02 [95 % CI 1.62-5.63] for density ≥50 % vs. <10 %, p-heterogeneity = 0.17) and appeared to be stronger in postmenopausal women currently using hormones compared with postmenopausal women who never used PMH (OR = 4.50 [95 % CI 2.99-6.78] vs. 3.02, p-heterogeneity = 0.20) or with past hormone use (OR = 4.50 vs. 3.71 [95 % CI 1.90-7.23], p-heterogeneity = 0.23). CONCLUSIONS: Findings on associations by menopausal status/hormone use are suggestive and should be examined in additional larger studies.

15 Article Relationship between breast cancer risk factors and mammographic breast density in the Fernald Community Cohort. 2012

Yaghjyan, L / Mahoney, M C / Succop, P / Wones, R / Buckholz, J / Pinney, S M. ·Department of Environmental Health, University of Cincinnati College of Medicine, PO Box 670056, Cincinnati, OH 45267, USA. ·Br J Cancer · Pubmed #22281662.

ABSTRACT: BACKGROUND: We investigated associations of known breast cancer risk factors with breast density, a well-established and very strong predictor of breast cancer risk. METHODS: This nested case-control study included breast cancer-free women, 265 with high and 860 with low breast density. Women were required to be 40-80 years old and should have a body mass index (BMI) <35 at the time of the index mammogram. Information on covariates was obtained from annual questionnaires. RESULTS: In the overall analysis, breast density was inversely associated with BMI at mammogram (P for trend<0.001), and parity (P for trend=0.02) and positively associated with alcohol consumption (ever vs never: odds ratio 2.0, 95% confidence interval 1.4-2.8). Alcohol consumption was positively associated with density, and the association was stronger in women with a family history of breast cancer (P<0.001) and in women with hormone replacement therapy (HRT) history (P<0.001). Parity was inversely associated with density in all subsets, except premenopausal women and women without a family history. The association of parity with density was stronger in women with HRT history (P<0.001). CONCLUSION: The associations of alcohol and parity with breast density appear to be in reverse direction, but stronger in women with a family history of breast cancer and women who ever used HRT.

16 Article Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to tumor characteristics. 2011

Yaghjyan, Lusine / Colditz, Graham A / Collins, Laura C / Schnitt, Stuart J / Rosner, Bernard / Vachon, Celine / Tamimi, Rulla M. ·Department of Surgery, Division of Public Health Sciences, Washington University in St Louis School of Medicine, St Louis, MO, USA. ·J Natl Cancer Inst · Pubmed #21795664.

ABSTRACT: BACKGROUND: Few studies that investigated the associations between breast density and subsequent breast cancer according to tumor characteristics have produced inconclusive findings. We aimed to determine whether the associations between breast density and subsequent breast cancer varied by tumor characteristics. METHODS: We included 1042 postmenopausal women diagnosed with breast cancer between June 1, 1989, and June 30, 2004, and 1794 matched control subjects from the Nurses' Health Study, an ongoing prospective cohort study of 121 701 registered female nurses across the United States. Breast density was estimated from digitized images using computerized techniques. Information on breast cancer risk factors was obtained prospectively from biennial questionnaires before the date of cancer diagnosis for case subjects and matched control subjects. Polychotomous logistic regression was used to assess associations of breast density with tumor subtypes based on invasiveness, histology, size, grade, receptor status, and involvement of lymph nodes. All tests of statistical significance were two-sided. RESULTS: The risk of breast cancer increased progressively with increase in percent breast density (P(trend) < .001). Women with higher breast density (≥50%) showed a 3.39-fold (odds ratio = 3.39, 95% confidence interval = 2.46 to 4.68) increased risk of breast cancer compared with women with lower breast density (<10%). The associations between breast density and breast cancer risk were stronger for in situ compared with invasive tumors (P(heterogeneity) < .01), high-grade compared with low-grade tumors (P(heterogeneity) = .02), larger (>2 cm) compared with smaller (≤2 cm) tumors (P(heterogeneity) < .01), and estrogen receptor-negative compared with estrogen receptor-positive tumors (P(heterogeneity) = .04). There were no differences in associations by tumor histology, involvement of lymph nodes, and progesterone receptor and HER2 status (P(heterogeneity) > .05). CONCLUSIONS: The findings suggest that higher mammographic density is associated with more aggressive tumor characteristics and also with in situ tumors.