Skip to main content

Advertisement

Springer Nature Link
Log in

The metabolic syndrome and mammographic breast density in a racially diverse and predominantly immigrant sample of women

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

The metabolic syndrome [MetS, clustering of elevated blood pressure, triglycerides and glucose, reduced high-density lipoprotein cholesterol (HDL-C), abdominal obesity] has been associated with increased breast cancer risk, but less is known about its association with mammographic breast density, a strong risk factor for breast cancer.

Methods

We collected data on risk factors, body size, and blood pressure via in-person interviews and examinations and measured glucose, triglycerides, and HDL-C from dried blood spots from women recruited through a mammography screening clinic (n = 373; 68 % Hispanic, 17 % African-American, 63 % foreign born). We performed linear regression models to examine the associations of each MetS component and the MetS cluster (≥3 components) with percent density and dense breast area, measured using a computer-assisted technique and Cumulus software.

Results

About 45 % of women had the MetS, with the prevalence of the individual components ranging from 68 % for abdominal obesity to 33 % for elevated triglycerides. The prevalence of the MetS increased with higher body mass index (BMI) and postmenopausal status, but did not vary substantially by ethnicity, immigrant generational status, parity, age at menarche, or alcohol consumption. Low HDL-C (<50 mg/dL), but not the MetS cluster or the other MetS components, was associated with larger dense breast area after adjusting for age, BMI, fasting time, and educational attainment (β = 8.77, 95 % CI 2.39, 15.14). The MetS and its individual components were not associated with BMI-adjusted percent density.

Conclusions

HDL-C alone may have an influence on dense breast tissue that is independent of BMI, and may be in the same direction as its association with breast cancer risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

MetS:

Metabolic syndrome

HDL-C:

High-density lipoprotein cholesterol

References

  1. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112(17):2735–2752. doi:10.1161/CIRCULATIONAHA.105.169404

    Article  PubMed  Google Scholar 

  2. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA et al (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120(16):1640–1645. doi:10.1161/CIRCULATIONAHA.109.192644

    Article  CAS  PubMed  Google Scholar 

  3. Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D (2012) Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care 35(11):2402–2411. doi:10.2337/dc12-0336

    Article  PubMed Central  PubMed  Google Scholar 

  4. Esposito K, Chiodini P, Capuano A, Bellastella G, Maiorino MI, Rafaniello C et al (2013) Metabolic syndrome and postmenopausal breast cancer: systematic review and meta-analysis. Menopause 20(12):1301–1309. doi:10.1097/GME.0b013e31828ce95d

    Article  PubMed  Google Scholar 

  5. Rose DP, Haffner SM, Baillargeon J (2007) Adiposity, the metabolic syndrome, and breast cancer in African–American and white American women. Endocr Rev 28(7):763–777. doi:10.1210/er.2006-0019

    Article  CAS  PubMed  Google Scholar 

  6. Maiti B, Kundranda MN, Spiro TP, Daw HA (2009) The association of metabolic syndrome with triple-negative breast cancer. Breast Cancer Res Treat 121(2):479–483. doi:10.1007/s10549-009-0591-y

    Article  PubMed  Google Scholar 

  7. Lopez R, Agullo P, Lakshmanaswamy R (2013) Links between obesity, diabetes and ethnic disparities in breast cancer among Hispanic populations. Obes Rev 14(8):679–691. doi:10.1111/obr.12030

    Article  CAS  PubMed  Google Scholar 

  8. Berrino F, Villarini A, Traina A, Bonanni B, Panico S, Mano MP et al (2014) Metabolic syndrome and breast cancer prognosis. Breast Cancer Res Treat 147(1):159–165. doi:10.1007/s10549-014-3076-6

    Article  PubMed  Google Scholar 

  9. Bjorge T, Lukanova A, Jonsson H, Tretli S, Ulmer H, Manjer J et al (2010) Metabolic syndrome and breast cancer in the me-can (metabolic syndrome and cancer) project. Cancer Epidemiol Biomark Prev 19(7):1737–1745. doi:10.1158/1055-9965.EPI-10-0230

    Article  Google Scholar 

  10. Oza AM, Boyd NF (1993) Mammographic parenchymal patterns: a marker of breast cancer risk. Epidemiol Rev 15(1):196–208

    CAS  PubMed  Google Scholar 

  11. Yaghjyan L, Colditz GA, Rosner B, Tamimi RM (2013) Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to the time since the mammogram. Cancer Epidemiol Biomark Prev 22(6):1110–1117. doi:10.1158/1055-9965.EPI-13-0169

    Article  Google Scholar 

  12. McCormack VA, dos Santos Silva I (2006) Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomark Prev 15(6):1159–1169. doi:10.1158/1055-9965.EPI-06-0034

    Article  Google Scholar 

  13. Pettersson A, Graff RE, Ursin G, Santos Silva ID, McCormack V, Baglietto L et al (2014) Mammographic density phenotypes and risk of breast cancer: a meta-analysis. J Natl Cancer Inst. doi:10.1093/jnci/dju078

    PubMed  Google Scholar 

  14. Boyd NF, Martin LJ, Yaffe MJ, Minkin S (2011) Mammographic density and breast cancer risk: current understanding and future prospects. Breast Cancer Res 13(6):223. doi:10.1186/bcr2942

    Article  PubMed Central  PubMed  Google Scholar 

  15. Yaghjyan L, Colditz GA, Wolin K (2012) Physical activity and mammographic breast density: a systematic review. Breast Cancer Res Treat 135(2):367–380. doi:10.1007/s10549-012-2152-z

    Article  PubMed Central  PubMed  Google Scholar 

  16. Roubidoux MA, Kaur JS, Griffith KA, Sloan J, Wilson C, Novotny P et al (2003) Correlates of mammogram density in southwestern Native-American women. Cancer Epidemiol Biomark Prev 12(6):552–558

    Google Scholar 

  17. Sellers TA, Jensen LE, Vierkant RA, Fredericksen ZS, Brandt KR, Giuliano AR et al (2007) Association of diabetes with mammographic breast density and breast cancer in the Minnesota breast cancer family study. Cancer Cause Control 18(5):505–515. doi:10.1007/s10552-007-0128-9

    Article  Google Scholar 

  18. Boyd NF, Lockwood GA, Byng JW, Little LE, Yaffe MJ, Tritchler DL (1998) The relationship of anthropometric measures to radiological features of the breast in premenopausal women. Br J Cancer 78(9):1233–1238

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Boyd NF, Martin LJ, Sun L, Guo H, Chiarelli A, Hislop G et al (2006) Body size, mammographic density, and breast cancer risk. Cancer Epidemiol Biomark Prev 15(11):2086–2092

    Article  Google Scholar 

  20. Reeves KW, Stone RA, Modugno F, Ness RB, Vogel VG, Weissfeld JL et al (2009) Longitudinal association of anthropometry with mammographic breast density in the study of women’s health across the nation. Int J Cancer 124(5):1169–1177

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Stone J, Warren RM, Pinney E, Warwick J, Cuzick J (2009) Determinants of percentage and area measures of mammographic density. Am J Epidemiol 170(12):1571–1578. doi:10.1093/aje/kwp313

    Article  PubMed  Google Scholar 

  22. Conroy SM, Butler LM, Harvey D, Gold EB, Sternfeld B, Greendale GA et al (2011) Metabolic syndrome and mammographic density: the study of women’s health across the nation. Int J Cancer 129(7):1699–1707. doi:10.1002/ijc.25790

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Rice MS, Biessy C, Lajous M, Bertrand KA, Tamimi RM, Torres-Mejia G et al (2013) Metabolic syndrome and mammographic density in Mexican women. Cancer Prev Res 6(7):701–710. doi:10.1158/1940-6207.CAPR-12-0475

    Article  CAS  Google Scholar 

  24. Tamburrini AL, Woolcott CG, Boyd NF, Yaffe MJ, Terry T, Yasui Y et al (2011) Associations between mammographic density and serum and dietary cholesterol. Breast Cancer Res Treat 125(1):181–189. doi:10.1007/s10549-010-0927-7

    Article  CAS  PubMed  Google Scholar 

  25. Boyd NF, Connelly P, Byng J, Yaffe M, Draper H, Little L et al (1995) Plasma lipids, lipoproteins and mammographic densities. Cancer Epidemiol Biomark Prev 4(7):727–733

    CAS  Google Scholar 

  26. Maskarinec G, Lyu LC, Meng L, Theriault A, Ursin G (2001) Determinants of mammographic densities among women of Asian, Native Hawaiian and Caucasian ancestry. Ethn Dis 11(1):44–50

    CAS  PubMed  Google Scholar 

  27. Aiello EJ, Tworoger SS, Yasui Y, Stanczyk FZ, Potter J, Ulrich CM et al (2005) Associations among circulating sex hormones, insulin-like growth factor, lipids, and mammographic density in postmenopausal women. Cancer Epidemiol Biomark Prev 14(6):1411–1417. doi:10.1158/1055-9965.EPI-04-0920

    Article  CAS  Google Scholar 

  28. Tehranifar P, Reynolds D, Fan X, Boden-Albala B, Engmann NJ, Flom JD et al (2014) Multiple metabolic risk factors and mammographic breast density. Ann Epidemiol 24(6):479–483. doi:10.1016/j.annepidem.2014.02.011

    Article  PubMed Central  PubMed  Google Scholar 

  29. Beltran-Sanchez H, Harhay MO, Harhay MM, McElligott S (2013) Prevalence and trends of metabolic syndrome in the adult U.S. population, 1999–2010. J Am Coll Cardiol 62(8):697–703. doi:10.1016/j.jacc.2013.05.064

    Article  PubMed Central  PubMed  Google Scholar 

  30. Keegan TH, John EM, Fish KM, Alfaro-Velcamp T, Clarke CA, Gomez SL (2010) Breast cancer incidence patterns among California Hispanic women: differences by nativity and residence in an enclave. Cancer Epidemiol Biomark Prev 19(5):1208–1218. doi:10.1158/1055-9965.EPI-10-0021

    Article  Google Scholar 

  31. Borrell LN, Castor D, Conway FP, Terry MB (2006) Influence of nativity status on breast cancer risk among US black women. J Urban Health 83(2):211–220. doi:10.1007/s11524-005-9014-5

    Article  PubMed Central  PubMed  Google Scholar 

  32. Habel LA, Capra AM, Oestreicher N, Greendale GA, Cauley JA, Bromberger J et al (2007) Mammographic density in a multiethnic cohort. Menopause 14(5):891–899

    Article  PubMed  Google Scholar 

  33. Tseng M, Byrne C, Evers KA, London WT, Daly MB (2006) Acculturation and breast density in foreign-born, U.S. Chinese women. Cancer Epidemiol Biomark Prev 15(7):1301–1305

    Article  Google Scholar 

  34. Maskarinec G, Pagano I, Chen Z, Nagata C, Gram IT (2007) Ethnic and geographic differences in mammographic density and their association with breast cancer incidence. Breast Cancer Res Treat 104(1):47–56. doi:10.1007/s10549-006-9387-5

    Article  PubMed  Google Scholar 

  35. McCormack VA, Perry N, Vinnicombe SJ, Silva Idos S (2008) Ethnic variations in mammographic density: a British multiethnic longitudinal study. Am J Epidemiol 168(4):412–421. doi:10.1093/aje/kwn169

    Article  PubMed  Google Scholar 

  36. Rodriguez F, Naderi S, Wang Y, Johnson CE, Foody JM (2013) High prevalence of metabolic syndrome in young Hispanic women: findings from the national sister to sister campaign. Metab Syndr Relat disord 11(2):81–86. doi:10.1089/met.2012.0109

    Article  CAS  PubMed  Google Scholar 

  37. Olson EC, Van Wye G, Kerker B, Thorpe L, Frieden TR (2006) Take care inwood and Washington heights (2nd ed). Retrieved from http://www.nyc.gov/html/doh/downloads/pdf/data/2006chp-301.pdf

  38. Abraido-Lanza AF, Martins MC, Shelton RC, Florez KR (2015) Breast cancer screening among Dominican Latinas: a closer look at fatalism and other social and cultural factors. Health Educ Behav. doi:10.1177/1090198115580975

  39. Third Report of the National Cholesterol Education Program (NCEP) (2002) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 106(25):3143–3421

    Google Scholar 

  40. Byng JW, Boyd NF, Fishell E, Jong RA, Yaffe MJ (1994) The quantitative analysis of mammographic densities. Phys Med Biol 39(10):1629–1638

    Article  CAS  PubMed  Google Scholar 

  41. Borugian MJ, Spinelli JJ, Gordon PB, Abanto Z, Brooks-Wilson A, Pollak MN et al (2014) Fasting insulin and endogenous hormones in relation to premenopausal breast density (Canada). Cancer Cause Control 25(3):385–394. doi:10.1007/s10552-014-0339-9

    Article  Google Scholar 

  42. Woolcott CG, Courneya KS, Boyd NF, Yaffe MJ, McTiernan A, Brant R et al (2013) Association between sex hormones, glucose homeostasis, adipokines, and inflammatory markers and mammographic density among postmenopausal women. Breast Cancer Res Treat 139(1):255–265. doi:10.1007/s10549-013-2534-x

    Article  CAS  PubMed  Google Scholar 

  43. Furberg AS, Jasienska G, Bjurstam N, Torjesen PA, Emaus A, Lipson SF et al (2005) Metabolic and hormonal profiles: HDL cholesterol as a plausible biomarker of breast cancer risk. The Norwegian EBBA study. Cancer Epidemiol Biomark Prev 14(1):33–40

    CAS  Google Scholar 

  44. Flote VG, Frydenberg H, Ursin G, Iversen A, Fagerland MW, Ellison PT et al (2015) High-density lipoprotein-cholesterol, daily estradiol and progesterone, and mammographic density phenotypes in premenopausal women. Cancer prev Res 8(6):535–544. doi:10.1158/1940-6207.CAPR-14-0267

    Article  CAS  Google Scholar 

  45. Ferraroni M, Gerber M, Decarli A, Richardson S, Marubini E, Crastes de Paulet P et al (1993) HDL-cholesterol and breast cancer: a joint study in northern Italy and southern France. Int J Epidemiol 22(5):772–780

    Article  CAS  PubMed  Google Scholar 

  46. Gaard M, Tretli S, Urdal P (1994) Risk of breast cancer in relation to blood lipids: a prospective study of 31,209 Norwegian women. Cancer Causes Control 5(6):501–509

    Article  CAS  PubMed  Google Scholar 

  47. Martin LJ, Melnichouk O, Huszti E, Connelly PW, Greenberg CV, Minkin S et al (2015) Serum lipids, lipoproteins, and risk of breast cancer: a nested case-control study using multiple time points. J Natl Cancer Inst 107(5). doi:10.1093/jnci/djv032

  48. Llanos AA, Makambi KH, Tucker CA, Wallington SF, Shields PG, Adams-Campbell LL (2012) Cholesterol, lipoproteins, and breast cancer risk in African American women. Ethn Dis 22(3):281–287

    PubMed Central  PubMed  Google Scholar 

  49. Furberg AS, Veierod MB, Wilsgaard T, Bernstein L, Thune I (2004) Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. J Natl Cancer Inst 96(15):1152–1160. doi:10.1093/jnci/djh216

    Article  CAS  PubMed  Google Scholar 

  50. Kim Y, Park SK, Han W, Kim DH, Hong YC, Ha EH et al (2009) Serum high-density lipoprotein cholesterol and breast cancer risk by menopausal status, body mass index, and hormonal receptor in Korea. Cancer Epidemiol Biomark Prev 18(2):508–515. doi:10.1158/1055-9965.EPI-08-0133

    Article  CAS  Google Scholar 

  51. Moorman PG, Hulka BS, Hiatt RA, Krieger N, Newman B, Vogelman JH et al (1998) Association between high-density lipoprotein cholesterol and breast cancer varies by menopausal status. Cancer Epidemiol Biomark Prev 7(6):483–488

    CAS  Google Scholar 

  52. Kucharska-Newton AM, Rosamond WD, Mink PJ, Alberg AJ, Shahar E, Folsom AR (2008) HDL-cholesterol and incidence of breast cancer in the ARIC cohort study. Ann Epidemiol 18(9):671–677. doi:10.1016/j.annepidem.2008.06.006

    Article  PubMed Central  PubMed  Google Scholar 

  53. Singh IM, Shishehbor MH, Ansell BJ (2007) High-density lipoprotein as a therapeutic target: a systematic review. JAMA 298(7):786–798. doi:10.1001/jama.298.7.786

    Article  CAS  PubMed  Google Scholar 

  54. Lakshmy R, Gupta R, Prabhakaran D, Snehi U, Reddy KS (2010) Utility of dried blood spots for measurement of cholesterol and triglycerides in a surveillance study. J Diabetes Sci Technol 4(2):258–262

    Article  PubMed Central  PubMed  Google Scholar 

  55. Lakshmy R, Mathur P, Gupta R, Shah B, Anand K, Mohan V et al (2012) Measurement of cholesterol and triglycerides from a dried blood spot in an Indian Council of Medical Research-World Health Organization multicentric survey on risk factors for noncommunicable diseases in India. J Clin Lipidol 6(1):33–41. doi:10.1016/j.jacl.2011.10.021

    Article  PubMed  Google Scholar 

  56. Quraishi R, Lakshmy R, Prabhakaran D, Mukhopadhyay AK, Jailkhani B (2006) Use of filter paper stored dried blood for measurement of triglycerides. Lipids Health Dis 5:20. doi:10.1186/1476-511X-5-20

    Article  PubMed Central  PubMed  Google Scholar 

  57. Abyholm AS (1981) Determination of glucose in dried filter paper blood spots. Scand J Clin Lab Investig 41(3):269–274

    Article  CAS  Google Scholar 

  58. Winocour PH, McKinnon GA, McMurray JR, Anderson DC (1985) Evaluation of the measurement of blood glucose levels on dried filter paper blood spots. Diabet Med 2(4):269–271

    CAS  PubMed  Google Scholar 

  59. McDade TW, Williams S, Snodgrass JJ (2007) What a drop can do: dried blood spots as a minimally invasive method for integrating biomarkers into population-based research. Demography 44(4):899–925

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This work was supported by grants from the Susan G. Komen Foundation [KG110331] and the National Cancer Institute [K07 CA151777]. We thank the study participants for contributing data to this research. We also thank Chidera Agu, Rachel Rhodes, Camille Rodriguez, Meredith Welch and Brenda Umana for data collection and Elizabeth Kerschner for laboratory analysis of blood samples.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA

    Parisa Tehranifar, Angeline Protacio, Sabine Oskar, Natalie J. Engmann & Mary Beth Terry

  2. Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA

    Parisa Tehranifar, Karen M. Schmitt & Mary Beth Terry

  3. Division of Academics, Columbia University School of Nursing, New York, NY, USA

    Karen M. Schmitt

  4. Avon Foundation Breast Imaging Center-New York Presbyterian, New York, NY, USA

    Karen M. Schmitt

  5. Department of Radiology, Columbia University Medical Center, New York, NY, USA

    Elise Desperito

  6. Department of Laboratory Medicine, University of Washington, Seattle, WA, USA

    Alan J. Potter

Authors
  1. Parisa Tehranifar
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Angeline Protacio
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Karen M. Schmitt
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Elise Desperito
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Sabine Oskar
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Alan J. Potter
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Natalie J. Engmann
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Mary Beth Terry
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Parisa Tehranifar.

Ethics declarations

Conflict of interest

Authors declare that they have no conflict of interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tehranifar, P., Protacio, A., Schmitt, K.M. et al. The metabolic syndrome and mammographic breast density in a racially diverse and predominantly immigrant sample of women. Cancer Causes Control 26, 1393–1403 (2015). https://doi.org/10.1007/s10552-015-0630-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-015-0630-4

Keywords