Overweight Women May Need More Frequent Mammograms

Women with higher than normal body mass index (BMI) may need shorter intervals between breast cancer screening, according to a recent study. The findings showed that BMI was the only consistent risk factor for detecting tumors larger than 2 cm overall and at interval screenings, and were associated with worse prognosis.

These findings will be presented next week at the Radiological Society of North America annual meeting next week.
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For their study, the researchers examined the incidence of invasive breast cancer among 2358 women who underwent screening between 2001 and 2008. They obtained data on tumor size and compared characteristics associated with tumors found under 2 cm with those larger than 2 cm. The odds ratios (OR) for the association between risk factors and the discovery of larger tumors at screening, such as percent density and body mass index (BMI), were calculated. In addition, the researchers estimated age-adjusted hazard ratios for disease progression, defined as first locoregional relapse, distant metastasis or death due to breast cancer.

BMI and PD were associated with larger tumors at diagnosis for screen-detected cancers. However, only BMI was associated with larger tumor size for interval cancers, whereas PD was associated with smaller tumors. Additionally, the researchers found that nulliparity was only significant for screen-detected cases.

In addition, larger tumor size and higher BMI among women with interval-detected cancer were associated with worse prognosis, but PD was not significantly associated with disease progression.

“BMI is the only risk factor consistently associated with being detected with a tumor larger than 2 cm-overall, among screen-detected cancers and among interval cancers,” the researcher concluded. “Among interval cancers, BMI was associated with worse prognosis.”

“In light of our findings, efforts to improve breast cancer screening by finding tumors while they are still small and improve prognosis, should focus on shortening the time interval between screenings for women with high BMI.”

—Melissa Weiss

Reference:

Strand F, Humphreys K, Holm J, et al. Large Breast Cancers in Women Attending Regular Screening: Risk Factors and Implications for Prognosis. Presented at: Radiological Society of North America annual meeting; November 26-December 1, 2017; Chicago, IL.