OJMI  Vol.3 No.4 , December 2013
Breast Density: Does It Vary among the Main Ethnic Groups in Malaysia?
Abstract: Breast cancer is one of the common cancers among Malaysians and there are associated risk factors which include breast density. Therefore, this study was done to determine the association of breast cancer risks among ethnic groups in relation to breast density. Mammography was done on 300 women with equal numbers of Malays, Chinese and Indians with a mean age of 53.35 ± 7.4 years. Mammograms were evaluated using BI-RADS (Breast Imaging Reporting and Data System) protocol by two independent radiologists for breast density categorization. Chi-square analysis showed an association between breast density and age factor (p < 0.05) whereas body mass index (BMI) was inversely associated with breast density (p > 0.05). There was significant difference in number of children and menopausal status (p < 0.05). Results showed that 65% of Chinese subjects had denser breast density composition as to 50% in Malays and 35% in Indians. There was significant difference between breast density of three ethnic groups (p < 0.05) with Chinese having 2.4 times denser breast (OR = 2.45, 95% CI: 1.466 - 3.948) followed by Malays (OR = 1.020, 95% CI: 0.681 - 1.689) and lowest in Indians (OR = 0.406, 95% CI: 0.247 - 0.668). Based on breast density, the Chinese are at a higher risk of developing breast cancer followed by Malays and lastly Indians.
Cite this paper: K. Kumari Chelliah, N. Shatirah Mohd Fandi Voon and H. Ahamad, "Breast Density: Does It Vary among the Main Ethnic Groups in Malaysia?," Open Journal of Medical Imaging, Vol. 3 No. 4, 2013, pp. 105-109. doi: 10.4236/ojmi.2013.34017.

[1]   Ministry of Health Malaysia, “Malaysian Cancer Statistic—Data and Figure,” Peninsular Malaysia, National Cancer Registry, 2006.

[2]   C. Byrne and C. Spernak, “What Is Breast Density?” Cambridge University Press, Cambridge, 2005.

[3]   A. Butler, “Breast Disease and Mammography,” Aids to Radiological Differential Diagnosis, Vol. 5, 2009, pp. 237-250.

[4]   C. M. Vachon, C. H. Van Gils, T. A. Sellers, K. Ghosh, S. Pruthi, K. R. Brandt, et al., “Mammographic Density, Breast Cancer Risk and Risk Prediction,” Breast Cancer Research, Vol. 9, 2007, pp. 217-226.

[5]   R. W. Pinsky and M. A. Helvie, “Mammographic Breast Density: Effect on Imaging and Breast Cancer Risk,” Journal of the National Comprehensive Cancer Network, Vol. 8, No. 10, 2010, pp. 1157-1164.

[6]   I. T. Gram, Y. Bremnes, G. Ursin, G. Maskarinec, N. Bjurstam and E. Lund, “Percentage Density, Wolfe’s and Tabar’s Mammgraphic Patterns: Agreement and Association with Risk Factors for Breast Cancer,” Breast Cancer Research, 2005.

[7]   L. T. Ernstoff, A. N. A. Tosteson, C. Kasales, J. Weiss, M. Goodrich, E. E. Hatch and P. A. Carney, “Breast Cancer Risk Factors in Relation to Breast Density (United States),” Cancer Causes and Control, Vol. 17, No. 10, 2006, pp. 1281-1290.

[8]   G. Maskarinec, I. Pagano, Z. Chen, C. Nagata and I. T. Gram, “Ethnic and Geographic Differences in Mammographic Density and Their Association with Breast Cancer Incidence,” Breast Cancer Research and Treatment, Vol. 104, No. 1, 2007, pp. 47-56.

[9]   V. A. McCormack, N. Perry, S. J. Vinnicombe and I. D. Santos Silva, “Ethnic Variations in Mammographic Density: A British Multiethnic Longitudinal Study,” Ameri- can Journal of Epidermiology, Vol. 168, No. 4, 2008, pp. 412-421.

[10]   N. Jamal, “A Study of Breast Composition Using Radiographic Techniques,” Tesis Dr. Fal, Fakulti Perubatan. Universiti Malaya, 2005.

[11]   N. F. Boyd, H. Guo, L. J. Martin, L. Sun, J. Stone, E. Fischell, R. A. Jong, G. Hislop, A. Chiarelli, S. Minkin and M. J. Yaffe, “Mammography Density and the Risk, and Detection of Breast Cancer,” New England Journal of Medicine, Vol. 356, No. 3, 2007, pp. 227-236.

[12]   D. Soares, M. Reid and M. James, “Age as Predictor Factor of Mammographic Breast Density in Jamaican Women,” Clinical Radiology, Vol. 57, No. 6, 2002, pp. 472-476.

[13]   C. M. Checka, J. E. Chun, F. R. Schnabell, J. Lee and H. Toth, “The Relationship of Mammographic Density and Age: Implications for Breast Canccer Screening,” American Journal of Roentgenology, Vol. 198, No. 3, 2012, pp. W292-W295.

[14]   C. L. Mulhall, “An Epidemiologic Study of Mammographic Density Measures and Common Polymorphisms in Gene of Lipoprotein Metabolism and the Growth Hormones Insuline Like Growth Factors I Axis,” Tesis Dr. Fal, Universiti of Toronto, Kanada, 2005.

[15]   G. Ursin, H. Ma, A. H. Wu, L. Bernstein, M. Salane, Y. R. Parisky, et al., “Mammographic Density and Breast Cancer in Three Ethnic Groups,” Cancer Epidemiology, Biomarkers & Prevention, Vol. 12, No. 4, 2003, pp. 332-338.

[16]   Z. Chen, A. H. Wu, W. J. Gauderman, L. Bernstein, H. Ma, M. C. Pike and G. Ursin, “Does Mammography Density Reflect Ethnic Differences in Breast Cancer Incidence Rates?” American Journal of Epidermiology, Vol. 159, No. 2, 2003, pp. 140-147.

[17]   D. Heng, F. Gao, R. Jong, E. Fishell, M. Yaffe, L. Martin, T. Li, J. Stone, L. Sun, J. Hopper and N. F. Boyd, “Risk Factors for Breast Cancer Associated with Mammographic Features in Singaporean Chinese Women,” Cancer Epidemiology, Biomarkers & Prevention, Vol. 13, No. 1, 2004, pp. 1751-1758.

[18]   G. Maskarinec, L. Meng and G. Ursin, “Ethnic Differences in Mammographic Densities,” International Journal of Epidemiology, Vol. 30, No. 5, 2001, pp. 959-965.

[19]   C. G. Woolcott, K. Koga, S. M. Conray, C. Byrne, C. Nagata, G. Ursin, et al., “Mammographic Density, Parity and Age at First Birth, and Risk of Breast Cancer: An Analysis of Four Case-Control Studies,” Breast Cancer Research and Treatment, Vol. 132, No. 3, 2012, pp. 1163-1171.

[20]   A. B. Crest, E. J. Aiello, M. L. Anderson, S. Diana and M. Buist, “Varying Levels of Family History of Breast Cancer in Relation to Mammographic Breast Density (United Stated),” Cancer Causes Control, Vol. 17, No. 6, 2006, pp. 843-850.

[21]   A. Y. El-Bastawissi, E. White, M. T. Mandelson and S. Taplin, “Reproductive and Hormonal Factors Associated with Mammographic Breast Density by Age (United States),” Cancer Causes and Control, Vol. 11, No. 10, 2000, pp. 955-963.