Breast density as a risk factor of development of ductal carcinoma in situ

Objectives . to reveal a potential relationship between the breast density, various radiographic patterns of the breast structure, and the risk of developing ductal adenocarcinoma in situ. Methods. In this study, 169 patients were divided into 2 groups according to the modern X-ray classification L. Tabar. All patients underwent a core biopsy with subsequent histological examination. The first group consisted of 57 women (33.7%) with tumors arising in the terminal ductal-lobular unit – acinar adenocarcinoma (AAB) unifocal and multifocal forms, and the second group – 112 women (66.3%) with types of ductal adenocarcinoma in situ (in situ DAB) and ductal adenocarcinoma in situ associated with the acinar form of breast cancer (DAB + AAB). Pathologic findings on mammography were assessed using the modern classification of L. Tabar. Evaluation of the breast density was made using ACR 2013 classification. The Pattern of radiologic breast structure was evaluated according to the classification of L. Tabar. Results . According to our results, statistically significant differences of the compared groups on the breast density were established (p < 0.001). In the first group, patients with a density of ACR 1 prevailed, the proportion of which was 52.6%. In the second group, the incidence of ACR 4 was highest, with a share of 32.1% among all patients. Thus, it was concluded that there is an association of the breast density ACR 3 and ACR 4 and risk of development of DAB. Conclusions . The high breast density, as well as the IV and V type of the breast structure according to L. Tabar's classification, are statistically associated with an increased risk of developing ductal carcinoma in situ (DAB). Our study also showed a statistically significant difference in the age of onset of ductal and acinar adenocarcinoma of the breast – 52 and 64, respectively.