Breast cancer research : BCR · 2026
Adherence to the WCRF/AICR cancer prevention recommendations and mammographic density.
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Fernández-Morata Julia, Pollán Marina, Fernández de Larrea Baz Nerea, Pachón-Olmos Vanessa, Ruíz-Moreno Emma, García-Pérez Javier, Castelló-Pastor Adela, Sierra María Ángeles, Lucas Pilar, Llobet Rafael, Stradella Agostina, Cantos Blanca, Ramón Y Cajal Teresa, Santisteban Marta, Seguí Miguel Ángel, Santaballa Bertrán Ana, Granja Mónica, Camps-Herrero Julia, Recalde Sabela, Méndez Miriam, Calvo Verges Nuria, Pérez-Gómez Beatriz, Pastor-Barriuso Roberto, Lope Virginia
Аннотация
BACKGROUND: Mammographic density (MD) is a known predictor of breast cancer risk and may be influenced by modifiable lifestyle factors. This study aimed to assess the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations prior to diagnosis and MD in women diagnosed with breast cancer.
METHODS: We analyzed data from 759 breast cancer patients recruited from eight Spanish hospitals enrolled in the case-case Breast Cancer & Density Association Study. Participants completed an epidemiological and a food frequency questionnaire. A standardized score was constructed to assess adherence to six WCRF/AICR recommendations. MD percentage was measured using the validated DM-Scan software on the digital mammogram of the contralateral, tumor-free, breast obtained prior to any treatment. Standardized prevalences and standardized prevalence ratios (SPRs) for four MD categories and for MD ≥ 50% across categories of adherence to the WCRF/AICR recommendations were estimated based on multinomial and binary multivariable logistic regression models.
RESULTS: Overall, adherence to the WCRF/AICR recommendations was not consistently associated with MD. However, the standardized prevalence of MD ≥ 50% was higher among women with high adherence compared to those with low adherence (SPR high vs. low = 1.73; 95% CI = 1.03-2.91). This positive association was particularly evident with the physical activity recommendation (SPR fully met vs. no/partially met = 1.51; 95% CI = 1.02-2.25).
CONCLUSIONS: Breast cancer participants with greater adherence to the WCRF/AICR recommendations prior to diagnosis, particularly to physical activity guidelines, showed higher percent MD at diagnosis. This association likely reflects lower absolute breast adiposity rather than a greater amount of fibroglandular tissue, and would therefore not imply an increased carcinogenic risk. These findings highlight the complex relationship between lifestyle behaviors and breast tissue composition.
METHODS: We analyzed data from 759 breast cancer patients recruited from eight Spanish hospitals enrolled in the case-case Breast Cancer & Density Association Study. Participants completed an epidemiological and a food frequency questionnaire. A standardized score was constructed to assess adherence to six WCRF/AICR recommendations. MD percentage was measured using the validated DM-Scan software on the digital mammogram of the contralateral, tumor-free, breast obtained prior to any treatment. Standardized prevalences and standardized prevalence ratios (SPRs) for four MD categories and for MD ≥ 50% across categories of adherence to the WCRF/AICR recommendations were estimated based on multinomial and binary multivariable logistic regression models.
RESULTS: Overall, adherence to the WCRF/AICR recommendations was not consistently associated with MD. However, the standardized prevalence of MD ≥ 50% was higher among women with high adherence compared to those with low adherence (SPR high vs. low = 1.73; 95% CI = 1.03-2.91). This positive association was particularly evident with the physical activity recommendation (SPR fully met vs. no/partially met = 1.51; 95% CI = 1.02-2.25).
CONCLUSIONS: Breast cancer participants with greater adherence to the WCRF/AICR recommendations prior to diagnosis, particularly to physical activity guidelines, showed higher percent MD at diagnosis. This association likely reflects lower absolute breast adiposity rather than a greater amount of fibroglandular tissue, and would therefore not imply an increased carcinogenic risk. These findings highlight the complex relationship between lifestyle behaviors and breast tissue composition.