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4. Vegetable and fruit consumption and the risk of hormone receptor–defined breast cancer in the EPIC cohort

Author

Emaus, Marleen J, Peeters, Petra HM, Bakker, Marije F, Overvad, Kim, Tjønneland, Anne, Olsen, Anja, Romieu, Isabelle, Ferrari, Pietro, Dossus, Laure, Boutron-Ruault, Marie Christine, Baglietto, Laura, Fortner, Renée T, Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Lagiou, Pagona, Trichopoulos, Dimitrios, Masala, Giovanna, Pala, Valeria, Panico, Salvatore, Tumino, Rosario, Polidoro, Silvia, Skeie, Guri, Lund, Eiliv, Weiderpass, Elisabete, Quirós, J Ramón, Travier, Noémie, Sánchez, María-José, Chirlaque, Maria-Dolores, Ardanaz, Eva, Dorronsoro, Miren, Winkvist, Anna, Wennberg, Maria, Bueno-de-Mesquita, H Bas, Khaw, Kay-Tee, Travis, Ruth C, Key, Timothy J, Aune, Dagfinn, Gunter, Marc, Riboli, Elio, and van Gils, Carla H

Published
2016
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6. Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study

Author

Steins Bisschop, Charlotte N, van Gils, Carla H, Emaus, Marleen J, Bueno-de-Mesquita, H Bas, Monninkhof, Evelyn M, Boeing, Heiner, Aleksandrova, Krasmira, Jenab, Mazda, Norat, Teresa, Riboli, Elio, Boutron-Rualt, Marie-Christine, Fagherazzi, Guy, Racine, Antoine, Palli, Domenico, Krogh, Vittorio, Tumino, Rosario, Naccarati, Alessio, Mattiello, Amalia, Argüelles, Marcial Vicente, Sanchez, Maria José, Tormo, Maria José, Ardanaz, Eva, Dorronsoro, Miren, Bonet, Catalina, Khaw, Kay-Tee, Key, Tim, Trichopoulou, Antonia, Orfanos, Philippos, Naska, Androniki, Kaaks, Rudolph R, Lukanova, Annekatrin, Pischon, Tobias, Ljuslinder, Ingrid, Jirström, Karin, Ohlsson, Bodil, Overvad, Kim, Landsvig Berentzen, Tina, Halkjaer, Jytte, Tjonneland, Anne, Weiderpass, Elisabete, Skeie, Guri, Braaten, Tonje, Siersema, Peter D, Freisling, Heinz, Ferrari, Pietro, Peeters, Petra HM, and May, Anne M

Published
2014
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9. Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

Author

Emaus, Marleen J., van Gils, Carla H., Bakker, Marije F., Steins Bisschop, Charlotte N., Monninkhof, Evelyn M., Bueno-de-Mesquita, H. B(as), Travier, Noémie, Berentzen, Tina Landsvig, Overvad, Kim, Tjnneland, Anne, Romieu, Isabelle, Rinaldi, Sabina, Chajes, Veronique, Gunter, Marc J., Clavel-Chapelon, Françoise, Fagherazzi, Guy, Mesrine, Sylvie, Chang-Claude, Jenny, Kaaks, Rudolf, Boeing, Heiner, Aleksandrova, Krasimira, Trichopoulou, Antonia, Naska, Androniki, Orfanos, Philippos, Palli, Domenico, Agnoli, Claudia, Tumino, Rosario, Vineis, Paolo, Mattiello, Amalia, Braaten, Tonje, Borch, Kristin Benjaminsen, Lund, Eiliv, Menéndez, Virginia, Sánchez, María-José, Navarro, Carmen, Barricarte, Aurelio, Amiano, Pilar, Sund, Malin, Andersson, Anne, Borgquist, Signe, Olsson, Åsa, Khaw, Kay-Tee, Wareham, Nick, Travis, Ruth C., Riboli, Elio, Peeters, Petra H.M., and May, Anne M.

Published
2014
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10. Identification of Risk of Cardiovascular Disease by Automatic Quantification of Coronary Artery Calcifications on Radiotherapy Planning CT Scans in Patients With Breast Cancer

Author

Gal, Roxanne, primary, van Velzen, Sanne G. M., additional, Hooning, Maartje J., additional, Emaus, Marleen J., additional, van der Leij, Femke, additional, Gregorowitsch, Madelijn L., additional, Blezer, Erwin L. A., additional, Gernaat, Sofie A. M., additional, Lessmann, Nikolas, additional, Sattler, Margriet G. A., additional, Leiner, Tim, additional, de Jong, Pim A., additional, Teske, Arco J., additional, Verloop, Janneke, additional, Penninkhof, Joan J., additional, Vaartjes, Ilonca, additional, Meijer, Hanneke, additional, van Tol-Geerdink, Julia J., additional, Pignol, Jean-Philippe, additional, van den Bongard, Desirée H. J. G., additional, Išgum, Ivana, additional, and Verkooijen, Helena M., additional

Published
2021
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11. Cost-Effectiveness of Magnetic Resonance Imaging Screening for Women With Extremely Dense Breast Tissue

Author

Geuzinge, H. Amarens, Bakker, Marije F., Heijnsdijk, Eveline A.M., van Ravesteyn, Nicolien T., Veldhuis, Wouter B., Pijnappel, Ruud M., de Lange, Stéphanie V., Emaus, Marleen J., Mann, Ritse M., Monninkhof, Evelyn M., de Koekkoek-Doll, Petra K., van Gils, Carla H., de Koning, Harry J., Geuzinge, H. Amarens, Bakker, Marije F., Heijnsdijk, Eveline A.M., van Ravesteyn, Nicolien T., Veldhuis, Wouter B., Pijnappel, Ruud M., de Lange, Stéphanie V., Emaus, Marleen J., Mann, Ritse M., Monninkhof, Evelyn M., de Koekkoek-Doll, Petra K., van Gils, Carla H., and de Koning, Harry J.

Abstract

BACKGROUND: Extremely dense breast tissue is associated with increased breast cancer risk and limited sensitivity of mammography. The DENSE trial showed that additional magnetic resonance imaging (MRI) screening in women with extremely dense breasts resulted in a substantial reduction in interval cancers. The cost-effectiveness of MRI screening for these women is unknown. METHODS: We used the MISCAN-breast microsimulation model to simulate several screening protocols containing mammography and/or MRI to estimate long-term effects and costs. The model was calibrated using results of the DENSE trial and adjusted to incorporate decreases in breast density with increasing age. Screening strategies varied in the number of MRIs and mammograms offered to women ages 50-75 years. Outcomes were numbers of breast cancers, life-years, quality-adjusted life-years (QALYs), breast cancer deaths, and overdiagnosis. Incremental cost-effectiveness ratios (ICERs) were calculated (3% discounting), with a willingness-to-pay threshold of €22 000. RESULTS: Calibration resulted in a conservative fit of the model regarding MRI detection. Both strategies of the DENSE trial were dominated (biennial mammography; biennial mammography plus MRI). MRI alone every 4 years was cost-effective with €15 620 per QALY. Screening every 3 years with MRI alone resulted in an incremental cost-effectiveness ratio of €37 181 per QALY. All strategies with mammography and/or a 2-year interval were dominated because other strategies resulted in more additional QALYs per additional euro. Alternating mammography and MRI every 2 years was close to the efficiency frontier. CONCLUSIONS: MRI screening is cost-effective for women with extremely dense breasts, when applied at a 4-year interval. For a willingness to pay more than €22 000 per QALY gained, MRI at a 3-year interval is cost-effective as well.

Published
2021

12. Coronary artery calcifications on breast cancer radiotherapy planning CT scans and cardiovascular risk: What do patients want to know?

Author

Trialbureau Beeld, Cancer, Onderzoek Radiotherapie, Epi Kanker Team A, Brain, MS Radiotherapie, Beeldverwerking ISI, Gal, Roxanne, Gregorowitsch, Madelijn L., Emaus, Marleen J., Blezer, Erwin LA, van der Leij, Femke, van Velzen, Sanne GM, van Tol-Geerdink, Julia J., Išgum, Ivana, Verkooijen, Helena M., Trialbureau Beeld, Cancer, Onderzoek Radiotherapie, Epi Kanker Team A, Brain, MS Radiotherapie, Beeldverwerking ISI, Gal, Roxanne, Gregorowitsch, Madelijn L., Emaus, Marleen J., Blezer, Erwin LA, van der Leij, Femke, van Velzen, Sanne GM, van Tol-Geerdink, Julia J., Išgum, Ivana, and Verkooijen, Helena M.

Published
2021

13. Identification of Risk of Cardiovascular Disease by Automatic Quantification of Coronary Artery Calcifications on Radiotherapy Planning CT Scans in Patients with Breast Cancer

Author

Trialbureau Beeld, Cancer, JC onderzoeksprogramma Kanker, Beeldverwerking ISI, Epi Kanker Team A, MS Radiotherapie, Onderzoek Radiotherapie, Brain, Researchgr. Cardiovasculaire Radiologie, Circulatory Health, MS Radiologie, Researchgr. Systems Radiology, Infection & Immunity, Regenerative Medicine and Stem Cells, Researchbureau DHL, Team Medisch, Datamanagement 1, Cardiovasculaire Epi Team 5, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Gal, Roxanne, Van Velzen, Sanne G.M., Hooning, Maartje J., Emaus, Marleen J., Van Der Leij, Femke, Gregorowitsch, Madelijn L., Blezer, Erwin L.A., Gernaat, Sofie A.M., Lessmann, Nikolas, Sattler, Margriet G.A., Leiner, Tim, De Jong, Pim A., Teske, Arco J., Verloop, Janneke, Penninkhof, Joan J., Vaartjes, Ilonca, Meijer, Hanneke, Van Tol-Geerdink, Julia J., Pignol, Jean Philippe, Van Den Bongard, Desirée H.J.G., Išgum, Ivana, Verkooijen, Helena M., Trialbureau Beeld, Cancer, JC onderzoeksprogramma Kanker, Beeldverwerking ISI, Epi Kanker Team A, MS Radiotherapie, Onderzoek Radiotherapie, Brain, Researchgr. Cardiovasculaire Radiologie, Circulatory Health, MS Radiologie, Researchgr. Systems Radiology, Infection & Immunity, Regenerative Medicine and Stem Cells, Researchbureau DHL, Team Medisch, Datamanagement 1, Cardiovasculaire Epi Team 5, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Gal, Roxanne, Van Velzen, Sanne G.M., Hooning, Maartje J., Emaus, Marleen J., Van Der Leij, Femke, Gregorowitsch, Madelijn L., Blezer, Erwin L.A., Gernaat, Sofie A.M., Lessmann, Nikolas, Sattler, Margriet G.A., Leiner, Tim, De Jong, Pim A., Teske, Arco J., Verloop, Janneke, Penninkhof, Joan J., Vaartjes, Ilonca, Meijer, Hanneke, Van Tol-Geerdink, Julia J., Pignol, Jean Philippe, Van Den Bongard, Desirée H.J.G., Išgum, Ivana, and Verkooijen, Helena M.

Published
2021

14. Supplemental Breast MRI for Women with Extremely Dense Breasts: Results of the Second Screening Round of the DENSE Trial

Author

Epi Kanker Team A, Cancer, JC onderzoeksprogramma Kanker, MS Radiologie, Pathologie, Brain, Divisie Beeld & Oncologie, Circulatory Health, Veenhuizen, Stefanie G A, de Lange, Stéphanie V, Bakker, Marije F, Pijnappel, Ruud M, Mann, Ritse M, Monninkhof, Evelyn M, Emaus, Marleen J, de Koekkoek-Doll, Petra K, Bisschops, Robertus H C, Lobbes, Marc B I, de Jong, Mathijn D F, Duvivier, Katya M, Veltman, Jeroen, Karssemeijer, Nico, de Koning, Harry J, van Diest, Paul J, Mali, Willem P T M, van den Bosch, Maurice A A J, van Gils, Carla H, Veldhuis, Wouter B, DENSE Trial Study Group, Epi Kanker Team A, Cancer, JC onderzoeksprogramma Kanker, MS Radiologie, Pathologie, Brain, Divisie Beeld & Oncologie, Circulatory Health, Veenhuizen, Stefanie G A, de Lange, Stéphanie V, Bakker, Marije F, Pijnappel, Ruud M, Mann, Ritse M, Monninkhof, Evelyn M, Emaus, Marleen J, de Koekkoek-Doll, Petra K, Bisschops, Robertus H C, Lobbes, Marc B I, de Jong, Mathijn D F, Duvivier, Katya M, Veltman, Jeroen, Karssemeijer, Nico, de Koning, Harry J, van Diest, Paul J, Mali, Willem P T M, van den Bosch, Maurice A A J, van Gils, Carla H, Veldhuis, Wouter B, and DENSE Trial Study Group

Published
2021

15. Meerwaarde Van Mri-Screening Bij Zeer Dicht Borstweefsel in Het Bevolkingsonderzoek Borstkanker

Author

de Lange, Stéphanie V., Bakker, Marije F., Pijnappel, Ruud M., Mann, Ritse M., Peeters, Petra H.M., Monninkhof, Evelyn M., Emaus, Marleen J., Loo, Claudette E., Bisschops, Robertus H.C., Lobbes, Marc B.I., de Jong, Mathijn D.F., Duvivier, Katya M., Veltman, Jeroen, Karssemeijer, Nico, de Koning, Harry J., van Diest, Paul J., Mali, Willem P.T.M., van den Bosch, Maurice A.A.J., Veldhuis, Wouter B., van Gils, Carla H., Public Health, Radiology & Nuclear Medicine, Radiology and nuclear medicine, and CCA - Imaging and biomarkers

Published
2020

16. Meerwaarde van MRI-screening bij zeer dicht borstweefsel in het bevolkingsonderzoek borstkanker

Author

Arts-Assistenten Onderwijs Radiologie, Arts-assistenten Radiologie, Cancer, JC onderzoeksprogramma Kanker, Epi Kanker Team A, MS Radiologie, Pathologie, Brain, Divisie Beeld & Oncologie, Circulatory Health, de Lange, Stéphanie V., Bakker, Marije F., Pijnappel, Ruud M., Mann, Ritse M., Peeters, Petra H.M., Monninkhof, Evelyn M., Emaus, Marleen J., Loo, Claudette E., Bisschops, Robertus H.C., Lobbes, Marc B.I., de Jong, Mathijn D.F., Duvivier, Katya M., Veltman, Jeroen, Karssemeijer, Nico, de Koning, Harry J., van Diest, Paul J., Mali, Willem P.T.M., van den Bosch, Maurice A.A.J., Veldhuis, Wouter B., van Gils, Carla H., Arts-Assistenten Onderwijs Radiologie, Arts-assistenten Radiologie, Cancer, JC onderzoeksprogramma Kanker, Epi Kanker Team A, MS Radiologie, Pathologie, Brain, Divisie Beeld & Oncologie, Circulatory Health, de Lange, Stéphanie V., Bakker, Marije F., Pijnappel, Ruud M., Mann, Ritse M., Peeters, Petra H.M., Monninkhof, Evelyn M., Emaus, Marleen J., Loo, Claudette E., Bisschops, Robertus H.C., Lobbes, Marc B.I., de Jong, Mathijn D.F., Duvivier, Katya M., Veltman, Jeroen, Karssemeijer, Nico, de Koning, Harry J., van Diest, Paul J., Mali, Willem P.T.M., van den Bosch, Maurice A.A.J., Veldhuis, Wouter B., and van Gils, Carla H.

Published
2020

17. Cost-Effectiveness of Magnetic Resonance Imaging Screening for Women With Extremely Dense Breast Tissue.

Author

Geuzinge, H Amarens, Bakker, Marije F, Heijnsdijk, Eveline A M, Ravesteyn, Nicolien T van, Veldhuis, Wouter B, Pijnappel, Ruud M, Lange, Stéphanie V de, Emaus, Marleen J, Mann, Ritse M, Monninkhof, Evelyn M, Koekkoek-Doll, Petra K de, Gils, Carla H van, Koning, Harry J de, group, the DENSE trial study, van Ravesteyn, Nicolien T, de Lange, Stéphanie V, de Koekkoek-Doll, Petra K, van Gils, Carla H, de Koning, Harry J, and DENSE trial study group

Subjects
MAGNETIC resonance imaging, BREAST cancer, DISEASE risk factors, COST effectiveness, WILLINGNESS to pay, RESEARCH, EARLY detection of cancer, MEDICAL screening, MAMMOGRAMS, EVALUATION research, COST benefit analysis, COMPARATIVE studies, RANDOMIZED controlled trials, RESEARCH funding, BREAST tumors
Abstract

Background: Extremely dense breast tissue is associated with increased breast cancer risk and limited sensitivity of mammography. The DENSE trial showed that additional magnetic resonance imaging (MRI) screening in women with extremely dense breasts resulted in a substantial reduction in interval cancers. The cost-effectiveness of MRI screening for these women is unknown.Methods: We used the MISCAN-breast microsimulation model to simulate several screening protocols containing mammography and/or MRI to estimate long-term effects and costs. The model was calibrated using results of the DENSE trial and adjusted to incorporate decreases in breast density with increasing age. Screening strategies varied in the number of MRIs and mammograms offered to women ages 50-75 years. Outcomes were numbers of breast cancers, life-years, quality-adjusted life-years (QALYs), breast cancer deaths, and overdiagnosis. Incremental cost-effectiveness ratios (ICERs) were calculated (3% discounting), with a willingness-to-pay threshold of €22 000.Results: Calibration resulted in a conservative fit of the model regarding MRI detection. Both strategies of the DENSE trial were dominated (biennial mammography; biennial mammography plus MRI). MRI alone every 4 years was cost-effective with €15 620 per QALY. Screening every 3 years with MRI alone resulted in an incremental cost-effectiveness ratio of €37 181 per QALY. All strategies with mammography and/or a 2-year interval were dominated because other strategies resulted in more additional QALYs per additional euro. Alternating mammography and MRI every 2 years was close to the efficiency frontier.Conclusions: MRI screening is cost-effective for women with extremely dense breasts, when applied at a 4-year interval. For a willingness to pay more than €22 000 per QALY gained, MRI at a 3-year interval is cost-effective as well. [ABSTRACT FROM AUTHOR]

Published
2021
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18. Supplemental MRI Screening for Women with Extremely Dense Breast Tissue

Author

Bakker, Marije F, de Lange, Stéphanie V, Pijnappel, Ruud M, Mann, Ritse M, Peeters, Petra H M, Monninkhof, Evelyn M, Emaus, Marleen J, Loo, Claudette E, Bisschops, Robertus H C, Lobbes, Marc B I, de Jong, Matthijn D F, Duvivier, Katya M, Veltman, Jeroen, Karssemeijer, Nico, de Koning, Harry J, van Diest, Paul J, Mali, Willem P T M, van den Bosch, Maurice A A J, Veldhuis, Wouter B, van Gils, Carla H, de Graaf, P, Public Health, Multi-Modality Medical Imaging, Beeldvorming, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: DA BV Medisch Specialisten Radiologie (9), Intensive care medicine, Radiology and nuclear medicine, CCA - Imaging and biomarkers, CCA - Cancer Treatment and quality of life, and Pathology

Subjects
medicine.medical_specialty, 030204 cardiovascular system & hematology, Research Support, law.invention, MAMMOGRAPHY, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, Breast cancer, Randomized controlled trial, law, Biopsy, Journal Article, Medicine, Mammography, 030212 general & internal medicine, Risk factor, Non-U.S. Gov't, NONCOMPLIANCE, RISK, Medicine(all), medicine.diagnostic_test, business.industry, Obstetrics, Incidence (epidemiology), Research Support, Non-U.S. Gov't, General Medicine, medicine.disease, CANCER, n/a OA procedure, Confidence interval, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], TRIALS, Extremely Dense Breast, business
Abstract

BACKGROUND: Extremely dense breast tissue is a risk factor for breast cancer and limits the detection of cancer with mammography. Data are needed on the use of supplemental magnetic resonance imaging (MRI) to improve early detection and reduce interval breast cancers in such patients.METHODS: In this multicenter, randomized, controlled trial in the Netherlands, we assigned 40,373 women between the ages of 50 and 75 years with extremely dense breast tissue and normal results on screening mammography to a group that was invited to undergo supplemental MRI or to a group that received mammography screening only. The groups were assigned in a 1:4 ratio, with 8061 in the MRI-invitation group and 32,312 in the mammography-only group. The primary outcome was the between-group difference in the incidence of interval cancers during a 2-year screening period.RESULTS: The interval-cancer rate was 2.5 per 1000 screenings in the MRI-invitation group and 5.0 per 1000 screenings in the mammography-only group, for a difference of 2.5 per 1000 screenings (95% confidence interval [CI], 1.0 to 3.7; PCONCLUSIONS: The use of supplemental MRI screening in women with extremely dense breast tissue and normal results on mammography resulted in the diagnosis of significantly fewer interval cancers than mammography alone during a 2-year screening period. (Funded by the University Medical Center Utrecht and others; DENSE ClinicalTrials.gov number, NCT01315015.).

Published
2019
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19. Bragatston study protocol: a multicentre cohort study on automated quantification of cardiovascular calcifications on radiotherapy planning CT scans for cardiovascular risk prediction in patients with breast cancer

Author

Emaus, Marleen J, primary, Išgum, Ivana, additional, van Velzen, Sanne G M, additional, van den Bongard, H J G Desirée, additional, Gernaat, Sofie A M, additional, Lessmann, Nikolas, additional, Sattler, Margriet G A, additional, Teske, Arco J, additional, Penninkhof, Joan, additional, Meijer, Hanneke, additional, Pignol, Jean-Philippe, additional, and Verkooijen, Helena M, additional

Published
2019
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20. Automatic quantification of calcifications in the coronary arteries and thoracic aorta on radiotherapy planning CT scans of Western and Asian breast cancer patients

Author

Gernaat, Sofie A M, van Velzen, Sanne G M, Koh, Vicky, Emaus, Marleen J, Išgum, Ivana, Lessmann, Nikolas, Moes, Shinta, Jacobson, Anouk, Tan, Poey W, Grobbee, Diederick E, van den Bongard, Desiree H J, Tang, Johann I, Verkooijen, Helena M, Gernaat, Sofie A M, van Velzen, Sanne G M, Koh, Vicky, Emaus, Marleen J, Išgum, Ivana, Lessmann, Nikolas, Moes, Shinta, Jacobson, Anouk, Tan, Poey W, Grobbee, Diederick E, van den Bongard, Desiree H J, Tang, Johann I, and Verkooijen, Helena M

Published
2018

22. Utility Scores and Preferences for Surgical and Organ-Sparing Approaches for Treatment of Intermediate and High-Risk Rectal Cancer

Author

MS Radiotherapie, Cancer, Onderzoek Radiotherapie, Trialbureau Beeld, JC onderzoeksprogramma Kanker, MS CGO, Epi Kanker Team A, Circulatory Health, Couwenberg, Alice M, Intven, Martijn P W, Burbach, Johannes P M, Emaus, Marleen J, van Grevenstein, Wilhelmina M U, Verkooijen, Helena M, MS Radiotherapie, Cancer, Onderzoek Radiotherapie, Trialbureau Beeld, JC onderzoeksprogramma Kanker, MS CGO, Epi Kanker Team A, Circulatory Health, Couwenberg, Alice M, Intven, Martijn P W, Burbach, Johannes P M, Emaus, Marleen J, van Grevenstein, Wilhelmina M U, and Verkooijen, Helena M

Published
2018

23. Automatic quantification of calcifications in the coronary arteries and thoracic aorta on radiotherapy planning CT scans of Western and Asian breast cancer patients

Author

Epi Kanker Team A, Cancer, JC onderzoeksprogramma Kanker, Beeldverwerking ISI, Trialbureau Beeld, Circulatory Health, Cardiovasculaire Epi Team 9, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiotherapie, Gernaat, Sofie A M, van Velzen, Sanne G M, Koh, Vicky, Emaus, Marleen J, Išgum, Ivana, Lessmann, Nikolas, Moes, Shinta, Jacobson, Anouk, Tan, Poey W, Grobbee, Diederick E, van den Bongard, Desiree H J, Tang, Johann I, Verkooijen, Helena M, Epi Kanker Team A, Cancer, JC onderzoeksprogramma Kanker, Beeldverwerking ISI, Trialbureau Beeld, Circulatory Health, Cardiovasculaire Epi Team 9, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiotherapie, Gernaat, Sofie A M, van Velzen, Sanne G M, Koh, Vicky, Emaus, Marleen J, Išgum, Ivana, Lessmann, Nikolas, Moes, Shinta, Jacobson, Anouk, Tan, Poey W, Grobbee, Diederick E, van den Bongard, Desiree H J, Tang, Johann I, and Verkooijen, Helena M

Published
2018

24. Supplemental Breast MRI for Women with Extremely Dense Breasts: Results of the Second Screening Round of the DENSE Trial

Author

Veenhuizen, Stefanie G. A., de Lange, Stéphanie V., Bakker, Marije F., Pijnappel, Ruud M., Mann, Ritse M., Monninkhof, Evelyn M., Emaus, Marleen J., de Koekkoek-Doll, Petra K., Bisschops, Robertus H. C., Lobbes, Marc B. I., de Jong, Mathijn D. F., Duvivier, Katya M., Veltman, Jeroen, Karssemeijer, Nico, de Koning, Harry J., van Diest, Paul J., Mali, Willem P. T. M., van den Bosch, Maurice A. A. J., van Gils, Carla H., and Veldhuis, Wouter B.

Abstract

The cancer detection rate in an incident breast MRI screening round after a negative mammographic examination is 5.8 per 1000 screening examinations—compared with 16.5 per 1000 screening examinations in the prevalent round—which is accompanied by a strong reduction in the number of false positive results.

Published
2021
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25. Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort

Author

Emaus, Marleen J. Peeters, Petra H. M. Bakker, Marije F. and Overvad, Kim Tjonneland, Anne Olsen, Anja Romieu, Isabelle and Ferrari, Pietro Dossus, Laure Boutron-Ruault, Marie Christine Baglietto, Laura Fortner, Renee T. Kaaks, Rudolf and Boeing, Heiner Trichopoulou, Antonia Lagiou, Pagona and Trichopoulos, Dimitrios Masala, Giovanna Pala, Valeria and Panico, Salvatore Tumino, Rosario Polidoro, Silvia Skeie, Guri Lund, Eiliv Weiderpass, Elisabete Ramon Quiros, J. and Travier, Noemie Sanchez, Maria-Jose Chirlaque, Maria-Dolores and Ardanaz, Eva Dorronsoro, Miren Winkvist, Anna Wennberg, Maria Bueno-de-Mesquita, H. Bas Khaw, Kay-Tee Travis, Ruth C. Key, Timothy J. Aune, Dagfinn Gunter, Marc Riboli, Elio van Gils, Carla H.

Abstract

Background: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk. Objective: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk. Design: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean +/- SD age: 50.8 +/- 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors. Results: After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile (5-quintile) (1): 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR- : HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk. Conclusion: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.

Published
2016

27. Patient Preferences for Minimally Invasive and Open Locoregional Treatment for Early-Stage Breast Cancer

Author

Onderzoek Beeld, UMC Utrecht, MS Radiologie, Cancer, JC onderzoeksprogramma Kanker, Epi Kanker Team A, Trialbureau Beeld, MS CGO, Knuttel, Floor, van den Bosch, Maurice A A J, Young-Afat, Danny A., Emaus, Marleen J., van den Bongard, Desirée H J G, Witkamp, Arjen J., Verkooijen, Helena M., Onderzoek Beeld, UMC Utrecht, MS Radiologie, Cancer, JC onderzoeksprogramma Kanker, Epi Kanker Team A, Trialbureau Beeld, MS CGO, Knuttel, Floor, van den Bosch, Maurice A A J, Young-Afat, Danny A., Emaus, Marleen J., van den Bongard, Desirée H J G, Witkamp, Arjen J., and Verkooijen, Helena M.

Published
2017

28. Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort

Author

Emaus, Marleen J., Peeters, Petra H. M., Bakker, Marije F., Overvad, Kim, Tjonneland, Anne, Olsen, Anja, Romieu, Isabelle, Ferrari, Pietro, Dossus, Laure, Boutron-Ruault, Marie Christine, Baglietto, Laura, Fortner, Renee T., Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Lagiou, Pagona, Trichopoulos, Dimitrios, Masala, Giovanna, Pala, Valeria, Panico, Salvatore, Tumino, Rosario, Polidoro, Silvia, Skeie, Guri, Lund, Eiliv, Weiderpass, Elisabete, Ramon Quiros, J., Travier, Noemie, Sanchez, Maria-Jose, Chirlaque, Maria-Dolores, Ardanaz, Eva, Dorronsoro, Miren, Winkvist, Anna, Wennberg, Maria, Bueno-de-Mesquita, H. Bas, Khaw, Kay-Tee, Travis, Ruth C., Key, Timothy J., Aune, Dagfinn, Gunter, Marc, Riboli, Elio, van Gils, Carla H., Emaus, Marleen J., Peeters, Petra H. M., Bakker, Marije F., Overvad, Kim, Tjonneland, Anne, Olsen, Anja, Romieu, Isabelle, Ferrari, Pietro, Dossus, Laure, Boutron-Ruault, Marie Christine, Baglietto, Laura, Fortner, Renee T., Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Lagiou, Pagona, Trichopoulos, Dimitrios, Masala, Giovanna, Pala, Valeria, Panico, Salvatore, Tumino, Rosario, Polidoro, Silvia, Skeie, Guri, Lund, Eiliv, Weiderpass, Elisabete, Ramon Quiros, J., Travier, Noemie, Sanchez, Maria-Jose, Chirlaque, Maria-Dolores, Ardanaz, Eva, Dorronsoro, Miren, Winkvist, Anna, Wennberg, Maria, Bueno-de-Mesquita, H. Bas, Khaw, Kay-Tee, Travis, Ruth C., Key, Timothy J., Aune, Dagfinn, Gunter, Marc, Riboli, Elio, and van Gils, Carla H.

Abstract

Background: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor–negative breast cancer risk. Objective: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor–defined breast cancer risk. Design: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors. Results: After a median follow-up of 11.5 y (IQR: 10.1–12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER−PR−)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5–quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER−PR− breast cancer (ER−PR−: HRquintile 5–quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5–quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor–defined breast cancer risk. Conclusion: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor–negative) breast cancer risk.

Published
2016
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29. Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

Author

Emaus, Marleen J. van Gils, Carla H. Bakker, Marije F. and Bisschop, Charlotte N. Steins Monninkhof, Evelyn M. and Bueno-de-Mesquita, H. B(as) Travier, Noemie Berentzen, Tina Landsvig Overvad, Kim Tjonneland, Anne Romieu, Isabelle and Rinaldi, Sabina Chajes, Veronique Gunter, Marc J. and Clavel-Chapelon, Francoise Fagherazzi, Guy Mesrine, Sylvie and Chang-Claude, Jenny Kaaks, Rudolf Boeing, Heiner and Aleksandrova, Krasimira Trichopoulou, Antonia Naska, Androniki and Orfanos, Philippos Palli, Domenico Agnoli, Claudia and Tumino, Rosario Vineis, Paolo Mattiello, Amalia Braaten, Tonje Borch, Kristin Benjaminsen Lund, Eiliv Menendez, Virginia Sanchez, Maria-Jose Navarro, Carmen Barricarte, Aurelio Amiano, Pilar Sund, Malin Andersson, Anne and Borgquist, Signe Olsson, Asa Khaw, Kay-Tee Wareham, Nick and Travis, Ruth C. Riboli, Elio Peeters, Petra H. M. May, Anne M.

Subjects
skin and connective tissue diseases
Abstract

Long-term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is unclear. We investigated the association between weight change in middle adulthood (i.e., women aged 40-50 years) and the risk of breast cancer before and after the age of 50. We included female participants of the European Prospective Investigation into Cancer and Nutrition cohort, with information on anthropometric measures at recruitment and after a median follow-up of 4.3 years. Annual weight change was categorized using quintiles taking quintile 2 and 3 as the reference category (-0.44 to 0.36 kg/year). Multivariable Cox proportional hazards regression analysis was used to examine the association. 205,723 women were included and 4,663 incident breast cancer cases were diagnosed during a median follow-up of 7.5 years (from second weight assessment onward). High weight gain (Q5: 0.83-4.98 kg/year) was related to a slightly, but significantly higher breast cancer risk (HRQ5_versus_Q2/3: 1.09, 95% CI: 1.01-1.18). The association was more pronounced for breast cancer diagnosed before or at age 50 (HRQ5_versus_Q2/3: 1.37, 95% CI: 1.02-1.85). Weight loss was not associated with breast cancer risk. There was no evidence for heterogeneity by hormone receptor status. In conclusion, high weight gain in middle adulthood increases the risk of breast cancer. The association seems to be more pronounced for breast cancer diagnosed before or at age 50. Our results illustrate the importance of avoiding weight gain in middle adulthood.

Published
2014

30. Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study

Author

Bisschop, Charlotte N. Steins van Gils, Carla H. Emaus, Marleen J. Bueno-de-Mesquita, H. Bas Monninkhof, Evelyn M. Boeing, Heiner Aleksandrova, Krasmira Jenab, Mazda Norat, Teresa and Riboli, Elio Boutron-Ruault, Marie-Christine Fagherazzi, Guy and Racine, Antoine Palli, Domenico Krogh, Vittorio Tumino, Rosario Naccarati, Alessio Mattiello, Amalia Vicente Argueeles, Marcial Jose Sanchez, Maria Jose Tormo, Maria and Ardanaz, Eva Dorronsoro, Miren Bonet, Catalina Khaw, Kay-Tee and Key, Tim Trichopoulou, Antonia Orfanos, Philippos Naska, Androniki Kaaks, Rudolph R. Lukanova, Annekatrin Pischon, Tobias Ljuslinder, Ingrid Jirstrom, Karin Ohlsson, Bodil and Overvad, Kim Berentzen, Tina Landsvig Halkjaer, Jytte and Tjonneland, Anne Weiderpass, Elisabete Skeie, Guri Braaten, Tonje Siersema, Peter D. Freisling, Heinz Ferrari, Pietro and Peeters, Petra H. M. May, Anne M.

Abstract

Background: A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change. Objective: We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk. Design: This was studied among 328,781 participants in the prospective European Prospective Investigation into Cancer Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating study (mean age: 50 y). Body weight was assessed at recruitment and on average 5 y later. Self-reported weight change (kg/y) was categorized in sex-specific quintiles, with quintiles 2 and 3 combined as the reference category (men: -0.6 to 0.3 kg/y; women: -0.4 to 0.4 kg/y). In the subsequent years, participants were followed for the occurrence of colon and rectal cancer (median period: 6.8 y). Multivariable Cox proportional hazards regression analyses were used to study the association. Results: A total of 1261 incident colon cancer and 747 rectal cancer cases were identified. ME at recruitment was statistically significantly associated with colon cancer risk in men (HR: 1.04; 95% CI: 1.02, 1.07). Moderate weight gain (quintile 4) in men increased risk further (HR: 1.32; 95% CI: 1.04, 1.68), but this relation did not show a clear trend. In women, BMI or weight gain was not related to subsequent risk of colon cancer. No statistically significant associations for weight loss and colon cancer or for BMI and weight changes and rectal cancer were found. Conclusions: BMI attained at adulthood was associated with colon cancer risk. Subsequent weight gain or loss was not related to colon or rectal cancer risk in men or women.

Published
2014

31. Geographic variation in volumetric breast density between screening regions in the Netherlands

Author

van der Waal, Danille, Emaus, Marleen J., Bakker, Marije F., den Heeten, Gerard J., Karssemeijer, Nico, Pijnappel, Ruud M., Veldhuis, Wouter B., Verbeek, Andre L. M., van Gils, Carla H., Broeders, Mireille J. M., van der Waal, Danille, Emaus, Marleen J., Bakker, Marije F., den Heeten, Gerard J., Karssemeijer, Nico, Pijnappel, Ruud M., Veldhuis, Wouter B., Verbeek, Andre L. M., van Gils, Carla H., and Broeders, Mireille J. M.

Published
2015

32. MR imaging as an additional screening modality for the detection of breast cancer in women aged 50-75 years with extremely dense breasts : The DENSE trial study design

Author

Emaus, Marleen J., Bakker, Marije F., Peeters, Petra H M, Loo, Claudette E., Mann, Ritse M., De Jong, Mathijn D F, Bisschops, Robertus H C, Veltman, Jeroen, Duvivier, Katya M., Lobbes, Marc B I, Pijnappel, Ruud M., Karssemeijer, Nico, De Koning, Harry J., Van Den Bosch, Maurice A A J, Monninkhof, Evelyn M., Mali, W.P.T.M., Veldhuis, WB, Van Gils, Carla H., Emaus, Marleen J., Bakker, Marije F., Peeters, Petra H M, Loo, Claudette E., Mann, Ritse M., De Jong, Mathijn D F, Bisschops, Robertus H C, Veltman, Jeroen, Duvivier, Katya M., Lobbes, Marc B I, Pijnappel, Ruud M., Karssemeijer, Nico, De Koning, Harry J., Van Den Bosch, Maurice A A J, Monninkhof, Evelyn M., Mali, W.P.T.M., Veldhuis, WB, and Van Gils, Carla H.

Published
2015

33. Geographic variation in volumetric breast density between screening regions in the Netherlands

Author

Trialbureau Beeld, JC onderzoeksprogramma Kanker, Epi Kanker Team A, Cancer, MS Radiologie, Circulatory Health, van der Waal, Danille, Emaus, Marleen J., Bakker, Marije F., den Heeten, Gerard J., Karssemeijer, Nico, Pijnappel, Ruud M., Veldhuis, Wouter B., Verbeek, Andre L. M., van Gils, Carla H., Broeders, Mireille J. M., Trialbureau Beeld, JC onderzoeksprogramma Kanker, Epi Kanker Team A, Cancer, MS Radiologie, Circulatory Health, van der Waal, Danille, Emaus, Marleen J., Bakker, Marije F., den Heeten, Gerard J., Karssemeijer, Nico, Pijnappel, Ruud M., Veldhuis, Wouter B., Verbeek, Andre L. M., van Gils, Carla H., and Broeders, Mireille J. M.

Published
2015

34. MR imaging as an additional screening modality for the detection of breast cancer in women aged 50-75 years with extremely dense breasts: The DENSE trial study design

Author

Trialbureau Beeld, JC onderzoeksprogramma Kanker, Epi Kanker Team A, Cancer, Epi Kanker Team 1, MS Radiologie, Emaus, Marleen J., Bakker, Marije F., Peeters, Petra H M, Loo, Claudette E., Mann, Ritse M., De Jong, Mathijn D F, Bisschops, Robertus H C, Veltman, Jeroen, Duvivier, Katya M., Lobbes, Marc B I, Pijnappel, Ruud M., Karssemeijer, Nico, De Koning, Harry J., Van Den Bosch, Maurice A A J, Monninkhof, Evelyn M., Mali, W.P.T.M., Veldhuis, WB, Van Gils, Carla H., Trialbureau Beeld, JC onderzoeksprogramma Kanker, Epi Kanker Team A, Cancer, Epi Kanker Team 1, MS Radiologie, Emaus, Marleen J., Bakker, Marije F., Peeters, Petra H M, Loo, Claudette E., Mann, Ritse M., De Jong, Mathijn D F, Bisschops, Robertus H C, Veltman, Jeroen, Duvivier, Katya M., Lobbes, Marc B I, Pijnappel, Ruud M., Karssemeijer, Nico, De Koning, Harry J., Van Den Bosch, Maurice A A J, Monninkhof, Evelyn M., Mali, W.P.T.M., Veldhuis, WB, and Van Gils, Carla H.

Published
2015

35. MR Imaging as an Additional Screening Modality for the Detection of Breast Cancer in Women Aged 50–75 Years with Extremely Dense Breasts: The DENSE Trial Study Design

Author

Emaus, Marleen J., primary, Bakker, Marije F., additional, Peeters, Petra H. M., additional, Loo, Claudette E., additional, Mann, Ritse M., additional, de Jong, Mathijn D. F., additional, Bisschops, Robertus H. C., additional, Veltman, Jeroen, additional, Duvivier, Katya M., additional, Lobbes, Marc B. I., additional, Pijnappel, Ruud M., additional, Karssemeijer, Nico, additional, de Koning, Harry J., additional, van den Bosch, Maurice A. A. J., additional, Monninkhof, Evelyn M., additional, Mali, Willem P. Th. M., additional, Veldhuis, Wouter B., additional, and van Gils, Carla H., additional

Published
2015
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36. Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study

Author

Bisschop, Charlotte N. Steins, van Gils, Carla H., Emaus, Marleen J., Bueno-de-Mesquita, H. Bas, Monninkhof, Evelyn M., Boeing, Heiner, Aleksandrova, Krasmira, Jenab, Mazda, Norat, Teresa, Riboli, Elio, Boutron-Rualt, Marie-Christine, Fagherazzi, Guy, Racine, Antoine, Palli, Domenico, Krogh, Vittorio, Tumino, Rosario, Naccarati, Alessio, Mattiello, Amalia, Vicente Argueeles, Marcial, Jose Sanchez, Maria, Jose Tormo, Maria, Ardanaz, Eva, Dorronsoro, Miren, Bonet, Catalina, Khaw, Kay-Tee, Key, Tim, Trichopoulou, Antonia, Orfanos, Philippos, Naska, Androniki, Kaaks, Rudolph R., Lukanova, Annekatrin, Pischon, Tobias, Ljuslinder, Ingrid, Jirstrom, Karin, Ohlsson, Bodil, Overvad, Kim, Berentzen, Tina Landsvig, Halkjaer, Jytte, Tjonneland, Anne, Weiderpass, Elisabete, Skeie, Guri, Braaten, Tonje, Siersema, Peter D., Freisling, Heinz, Ferrari, Pietro, Peeters, Petra H. M., May, Anne M., Bisschop, Charlotte N. Steins, van Gils, Carla H., Emaus, Marleen J., Bueno-de-Mesquita, H. Bas, Monninkhof, Evelyn M., Boeing, Heiner, Aleksandrova, Krasmira, Jenab, Mazda, Norat, Teresa, Riboli, Elio, Boutron-Rualt, Marie-Christine, Fagherazzi, Guy, Racine, Antoine, Palli, Domenico, Krogh, Vittorio, Tumino, Rosario, Naccarati, Alessio, Mattiello, Amalia, Vicente Argueeles, Marcial, Jose Sanchez, Maria, Jose Tormo, Maria, Ardanaz, Eva, Dorronsoro, Miren, Bonet, Catalina, Khaw, Kay-Tee, Key, Tim, Trichopoulou, Antonia, Orfanos, Philippos, Naska, Androniki, Kaaks, Rudolph R., Lukanova, Annekatrin, Pischon, Tobias, Ljuslinder, Ingrid, Jirstrom, Karin, Ohlsson, Bodil, Overvad, Kim, Berentzen, Tina Landsvig, Halkjaer, Jytte, Tjonneland, Anne, Weiderpass, Elisabete, Skeie, Guri, Braaten, Tonje, Siersema, Peter D., Freisling, Heinz, Ferrari, Pietro, Peeters, Petra H. M., and May, Anne M.

Abstract

Background: A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change. Objective: We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk. Design: This was studied among 328,781 participants in the prospective European Prospective Investigation into Cancer Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating study (mean age: 50 y). Body weight was assessed at recruitment and on average 5 y later. Self-reported weight change (kg/y) was categorized in sex-specific quintiles, with quintiles 2 and 3 combined as the reference category (men: -0.6 to 0.3 kg/y; women: -0.4 to 0.4 kg/y). In the subsequent years, participants were followed for the occurrence of colon and rectal cancer (median period: 6.8 y). Multivariable Cox proportional hazards regression analyses were used to study the association. Results: A total of 1261 incident colon cancer and 747 rectal cancer cases were identified. ME at recruitment was statistically significantly associated with colon cancer risk in men (HR: 1.04; 95% CI: 1.02, 1.07). Moderate weight gain (quintile 4) in men increased risk further (HR: 1.32; 95% CI: 1.04, 1.68), but this relation did not show a clear trend. In women, BMI or weight gain was not related to subsequent risk of colon cancer. No statistically significant associations for weight loss and colon cancer or for BMI and weight changes and rectal cancer were found. Conclusions: BMI attained at adulthood was associated with colon cancer risk. Subsequent weight gain or loss was not related to colon or rectal cancer risk in men or women.

Published
2014
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38. Geographic variation in volumetric breast density between screening regions in the Netherlands.

Author

Waal, Daniëlle, Emaus, Marleen, Bakker, Marije, Heeten, Gerard, Karssemeijer, Nico, Pijnappel, Ruud, Veldhuis, Wouter, Verbeek, André, Gils, Carla, Broeders, Mireille, van der Waal, Daniëlle, Emaus, Marleen J, Bakker, Marije F, den Heeten, Gerard J, Pijnappel, Ruud M, Veldhuis, Wouter B, Verbeek, André L M, van Gils, Carla H, and Broeders, Mireille J M

Subjects
BREAST cancer, MEDICAL screening, MAMMOGRAMS, SOCIAL status, REGIONAL differences, LINEAR statistical models, BREAST abnormalities, BREAST, BREAST tumors, CLINICAL trials, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, REGRESSION analysis, RESEARCH, RESIDENTIAL patterns, EVALUATION research, EARLY detection of cancer
Abstract

Objectives: Differences in breast density between populations may explain part of the variation in regional breast cancer screening performance. This study aimed to determine whether regional differences in breast density distribution are present in the Dutch screening population.Methods: As part of the DENSE trial, mammographic density was measured using a fully-automated volumetric method. The regions in our study were based on the geographic coverage of 14 reading units representing a large part of the Netherlands. General linear models were used.Results: Four hundred eighty-five thousand and twenty-one screening participants with a median age of 60 years were included (2013-2014). The proportion of women with heterogeneously or extremely dense breasts ranged from 32.5% to 45.7% between regions. Mean percent dense volume varied between 6.51% (95% confidence interval [CI]: 6.46-6.55) and 7.68% (95% CI: 7.66-7.71). Age differences could not explain the variation. Socio-economic status (SES) was positively associated with volumetric density in all analyses (low SES: 6.95% vs. high SES: 7.63%; p trend  < 0.0001), whereas a potential association between urbanisation and breast density only became apparent after SES adjustment.Conclusion: There appears to be geographic variation in mammographic density in the Netherlands, emphasizing the importance of including breast density as parameter in the evaluation of screening performance.Key Points: • Mammographic density may affect regional breast cancer screening performance. • Volumetric breast density varies across screening areas. • SES is positively associated with breast density. • Implications of volumetric breast density differences need to be studied further. [ABSTRACT FROM AUTHOR]

Published
2015
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