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Table 3 Overview of studies on association between breast density and breast cancer-specific survival

From: Breast density and breast cancer-specific survival by detection mode

Study Country Setting Study design Breast cancer deaths (N) Density measurement Outcome (univariable or minimally adjusted) Outcome (multivariable)
Olsen [20] Denmark Screening interval 2y, age 50-69y, 1991–2001 Cohort. Inclusion of interval and screen-detected cancer deaths. Fatty: 37 Mixed/dense: 53 Dichotomized measure with Fatty breasts and Mixed/Dense breasts Dense vs. Fatty
Case fatality RR 0.53 (0.34–0.82)a, Mortality: RR 1.78 (95%CI 1.17–2.72)
 
Olsson [21] Sweden Screening interval 18 to 24 m, age 50-69y, 1991–1996 Cohort. Inclusion of non-symptomatic and symptomatic cancer deaths. Fatty: 7
Moderate: 37
Dense: 32
Modification of the BI-RADS classification with Fatty, Moderate, and Dense breasts Dense vs. Fatty
All: HR 1.92 (0.85–4.35)
Non-symptomatic: HR 1.47 (0.41–5.27)
Symptomatic: HR 2.33 (0.80–6.80)
Dense vs. Fatty
All: HR 2.63 (1.10–6.30)b
Non-symptomatic: HR 2.04 (0.49–8.49)
Symptomatic: HR 3.40 (1.06–10.90)
Porter [22] England Screening interval 3y, age 50-64y, since 1987 Cohort. Inclusion of interval and screen-detected cancer deaths. BI-RADS 1: 186
BI-RADS 2: 126
BI-RADS 3: 373
BI-RADS 4: 74
BI-RADS breast density Dense vs. Fatty
No significant difference all cancer deaths (p = 0.12), screen-detected (p = 0.75), or interval (p = 0.82)
 
van Gils [23] The Netherlands Screening interval 2y, age 50-69y, 1977–1994 Cohort. Inclusion of screen-detected cancer deaths. 26 Visual assessment fatty (≤ 25%) and dense (> 25%) Dense vs. Fatty
10-year survival dense 73% vs. fatty 83% (survival p = 0.07) in first rounds, later rounds 10-year survival dense 89% vs. fatty 96% (no significant difference, p = 0.48)
 
Eriksson [24] Sweden Screening interval 24 m, age 50-74y, 1993–1995 Cohort. Inclusion of interval and screen-detected cancer deaths. Dense: 345 Nondense: 1055 Cumulus dichotomized into nondense (< 25%) and dense (≥ 25%) Interval vs. Screen-detected
All: HR 3.50 (2.25–5.44)c
Dense: HR 3.00 (1.26–7.17)
Nondense: HR 3.62 (2.17–6.06)
Interval vs. Screen-detected
All: HR 1.69 (1.03–2.76)d
Dense: HR 1.26 (0.47–3.38)
Nondense: HR 1.76 (1.01–3.09)
Gierach [25] US Age > 30y, 1996–2005 Cohort. Inclusion of screen-detected, interval, other screen-detected, clinically detected, and other cancer deaths. BI-RADS 1: 72
BI-RADS 2: 346
BI-RADS 3: 387
BI-RADS 4: 84
BI-RADS breast density Extremely dense vs. Scattered
All: HR 0.83 (0.65–1.07)e
Extremely dense vs. Scattered
All: HR 0.92 (0.71–1.19)f
Maskarinec [26] US 1993–1996 Case-control. Low density: 12
High density: 15
Cumulus dichotomized into low (< 35%) and high (> 35%)   High vs. Low percent density
All: HR 0.83 (0.36–1.92)g
Chiu [27] Sweden Age 45-59y, 1977–2004 Cohort. Mammographically detected, interval cancer, and refuser cases. Dense: 28
Nondense: 99
Tabár dichotomized into dense (IV and V) and nondense (I-III) Dense vs. Fatty
All: HR 1.41 (0.92–2.14)
Dense vs. Fatty
All: HR 1.75 (0.99–3.10)h
Zhang [28] US 1994–2008 Cohort.   BI-RADS breast density dichotomized into dense (3 and 4) and fatty (1 and 2)   Dense vs. Fatty
All: HR 0.91 (p-value = 0.1242)i
  1. In brackets behind the HRs are the 95% confidence intervals
  2. a Case fatality was based on breast cancer death, including all deaths was 0.60. This involves age-adjusted rate ratios
  3. b Adjusted for age at diagnosis, tumour size, axillary lymph node involvement, Nottingham grade, oestrogen receptor, progesterone receptor, diagnosis year, HRT use, BMI, and mode of detection (if applicable)
  4. c Adjusted for age, BMI, and hormone replacement therapy (HRT)
  5. d Adjusted for age, BMI, HRT, and lymph node metastases
  6. e Adjusted for registry site, age at diagnosis, and diagnosis year
  7. f Adjusted for registry site, age at diagnosis, diagnosis year, BMI, mode of detection, surgery/radiation, chemotherapy, and income
  8. g Adjusted for age at diagnosis, ethnicity, obesity, disease stage, and radiation treatment
  9. h Adjusted for age, tumour size, node status, grade, and BMI
  10. i Adjusted for age, ethnicity, and tumour stage