Fatores relacionados ao padrão radiológico de densidade mamária de usuárias de um Centro de Controle Oncológico do Acre, Brasil
DOI:
https://doi.org/10.34117/bjdv9n6-147Keywords:
densidade da mama, Câncer de Mama, mamografia, fatores de riscoAbstract
OBJETIVO: Analisar a relação entre o perfil clínico, reprodutivo, antropométrico e a densidade mamária de mulheres atendidas em um centro de referência em controle oncológico. MÉTODOS: Estudo observacional analítico transversal, incluindo 299 mulheres usuárias do serviço de mamografia do Centro de Controle Oncológico do Acre, Brasil. Mulheres com mama densa (duas categorias superiores da terminologia BI-RADS® (n=119) foram comparadas àquelas com mamas não-densas (duas categorias inferiores (n=180). Foram analisadas variáveis sócio demográficas (idade, escolaridade, renda, características fenotípicas, tabagismo e ingestão de álcool), variáveis clínicas (doenças autorreferidas e história familiar de câncer) e reprodutivas (histórico de amamentação, número de gestações e partos, histórico menstrual, uso de anticoncepcional oral, histerectomia e Terapia de Reposição de Estrógenos-TRE), e variáveis antropométricas (percentual de gordura corporal, Índice de Massa Corporal e circunferência da cintura). As variáveis qualitativas foram descritas como frequência absoluta (n) e relativa (%), e a diferença de proporção dos desfechos foi determinada pelo teste exato de Fisher. As variáveis quantitativas foram descritas pela mediana e intervalo interquartil, e comparadas pelo teste de Wilcoxon-Mann-Whitney e regressão logística múltipla. Para todos os testes estatísticos, o nível de significância foi de 5% (<0,05). RESULTADOS: Idade, IMC, percentual de gordura corporal, circunferência da cintura, tempo de amamentação e paridade foram fatores inversamente relacionados à densidade mamária. Adesão à TRE e tempo de tabagismo foram diretamente associados ao aumento da densidade mamária. CONCLUSÕES: Os padrões de densidade mamária parecem ser influenciados por fatores hereditários, biológicos e endócrinos, naturalmente relacionados aumento da idade e ao histórico reprodutivo. No entanto, fatores modificáveis de hábitos de vida parecem influenciar a densidade mamária, e devem ser melhor investigados, a fim de facilitar a detecção precoce de lesões mamárias e prevenir novos casos de câncer.
References
Byrne C, Schairer C, Wolfe J, Parekh N, Salane M, Brinton LA, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. Journal of the National Cancer Institute. 1995;87(21):1622-9.
Boyd NF. Mammographic density and risk of breast cancer. Am Soc Clin Oncol Educ Book. 2013.
Byrne C, Ursin G, Martin CF, Peck JD, Cole EB, Zeng D, et al. Mammographic Density Change With Estrogen and Progestin Therapy and Breast Cancer Risk. Journal of the National Cancer Institute. 2017;109(9).
Nishiyama K, Taira N, Mizoo T, Kochi M, Ikeda H, Iwamoto T, et al. Influence of breast density on breast cancer risk: a case control study in Japanese women. Breast Cancer. 2019.
Spak DA, Plaxco JS, Santiago L, Dryden MJ, Dogan BE. BI-RADS((R)) fifth edition: A summary of changes. Diagn Interv Imaging. 2017;98(3):179-90.
ACR ACoR. ACR BI-RADS atlas: breast imaging reporting and data system. 5 ed. Virginia2013.
Burton A, Maskarinec G, Perez-Gomez B, Vachon C, Miao H, Lajous M, et al. Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. PLoS Med. 2017;14(6):e1002335.
Pollan M, Lope V, Miranda-Garcia J, Garcia M, Casanova F, Sanchez-Contador C, et al. Adult weight gain, fat distribution and mammographic density in Spanish pre- and post-menopausal women (DDM-Spain). Breast cancer research and treatment. 2012;134(2):823-38.
Dorgan JF, Klifa C, Shepherd JA, Egleston BL, Kwiterovich PO, Himes JH, et al. Height, adiposity and body fat distribution and breast density in young women. Breast cancer research : BCR. 2012;14(4):R107.
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. International journal of cancer. 2011;129(2):440-8.
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 American journal of roentgenology. 1994;163(2):311-5.
Pape R, Spuur K, Umo P. Exploring correlations between the breast density of the women of Papua New Guinea and breast cancer risk factors. Radiography (Lond). 2019;25(4):e79-e87.
Azam S, Kemp Jacobsen K, Aro AR, von Euler-Chelpin M, Tjonneland A, Vejborg I, et al. Regular physical activity and mammographic density: a cohort study. Cancer causes & control : CCC. 2018;29(11):1015-25.
Castello A, Ascunce N, Salas-Trejo D, Vidal C, Sanchez-Contador C, Santamarina C, et al. Association Between Western and Mediterranean Dietary Patterns and Mammographic Density. Obstetrics and gynecology. 2016;128(3):574-81.
Qureshi SA, Ellingjord-Dale M, Hofvind S, Wu AH, Ursin G. Physical activity and mammographic density in a cohort of postmenopausal Norwegian women; a cross-sectional study. Springerplus. 2012;1(1):75.
CDC CfDCaP. EPI INFOTM. 7 ed. EUA: DHIS, Division of Health Informatics & Surveillance 2019.
Lee PH, Yu YY, McDowell I, Leung GM, Lam TH, Stewart SM. Performance of the international physical activity questionnaire (short form) in subgroups of the Hong Kong chinese population. The international journal of behavioral nutrition and physical activity. 2011;8:81.
Jelliffe DBWHO. Evaluación del estado de nutrición de la comunidad (con especial referencia a las encuestas en las regiones en desarrollo / Derrick B. Jelliffe ; obra preparada en consulta con veinticinco especialistas de varios países. Ginebra : Organización Mundial de la Salud. 1968:291 p.
Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ. 1995;311(7017):1401-5.
Kelemen LE, Pankratz VS, Sellers TA, Brandt KR, Wang A, Janney C, et al. Age-specific trends in mammographic density: the Minnesota Breast Cancer Family Study. American journal of epidemiology. 2008;167(9):1027-36.
Siqueira RFCB, Sá DSB, Pinto Neto AM, Cabello C, Conde DM, Paiva LHSdC, et al. Fatores associados à densidade mamográfica de mulheres na pós-menopausa. Revista Brasileira de Ginecologia e Obstetrícia. 2004;26:45-52.
Figueira RNM, Santos ÂId, Camargo ME, Koch HA. Fatores que influenciam o padrão radiológico de densidade das mamas. Radiologia Brasileira. 2003;36:287-92.
El-Bastawissi AY, White E, Mandelson MT, Taplin SH. Reproductive and hormonal factors associated with mammographic breast density by age (United States). Cancer causes & control : CCC. 2000;11(10):955-63.
Yaghjyan L, Mahoney MC, Succop P, Wones R, Buckholz J, Pinney SM. Relationship between breast cancer risk factors and mammographic breast density in the Fernald Community Cohort. British journal of cancer. 2012;106(5):996-1003.
Alvares BR, Freitas CHdA, Jales RM, Almeida OJd, Marussi EF. Mammographic density in asymptomatic menopausal women: correlation with clinical and sonographic findings. Radiologia Brasileira. 2012;45:149-54.
Colacurci N, Fornaro F, De Franciscis P, Mele D, Palermo M, del Vecchio W. Effects of a short-term suspension of hormone replacement therapy on mammographic density. Fertility and sterility. 2001;76(3):451-5.
Stone J, Warren RM, Pinney E, Warwick J, Cuzick J. Determinants of percentage and area measures of mammographic density. American journal of epidemiology. 2009;170(12):1571-8.
Fonseca-Alaniz MH, Takada J, Alonso-Vale MIC, Lima FB. O tecido adiposo como centro regulador do metabolismo. Arquivos Brasileiros de Endocrinologia & Metabologia. 2006;50:216-29.
Hart V, Reeves KW, Sturgeon SR, Reich NG, Sievert LL, Kerlikowske K, et al. The effect of change in body mass index on volumetric measures of mammographic density. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2015;24(11):1724-30.
Soguel L, Diorio C. Anthropometric factors, adult weight gain, and mammographic features. Cancer causes & control : CCC. 2016;27(3):333-40.
Martin LJ, Boyd NF. Mammographic density. Potential mechanisms of breast cancer risk associated with mammographic density: hypotheses based on epidemiological evidence. Breast cancer research : BCR. 2008;10(1):201.
Boyd NF, Martin LJ, Yaffe MJ, Minkin S. Mammographic density and breast cancer risk: current understanding and future prospects. Breast cancer research : BCR. 2011;13(6):223.
Cabanes A, Pastor-Barriuso R, Garcia-Lopez M, Pedraz-Pingarron C, Sanchez-Contador C, Vazquez Carrete JA, et al. Alcohol, tobacco, and mammographic density: a population-based study. Breast cancer research and treatment. 2011;129(1):135-47.
Maskarinec G, Takata Y, Pagano I, Lurie G, Wilkens LR, Kolonel LN. Alcohol consumption and mammographic density in a multiethnic population. International journal of cancer. 2006;118(10):2579-83.
Brand JS, Czene K, Eriksson L, Trinh T, Bhoo-Pathy N, Hall P, et al. Influence of lifestyle factors on mammographic density in postmenopausal women. PloS one. 2013;8(12):e81876.
Boyd NF, Martin LJ, Yaffe M, Minkin S. Mammographic density. Breast cancer research : BCR. 2009;11 Suppl 3:S4.
Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, et al. Mammographic density and the risk and detection of breast cancer. The New England journal of medicine. 2007;356(3):227-36.
