Mammographic density as a mediator for breast cancer risk: analytic approaches

Mammographic breast density has been found to be associated with breast cancer risk. Many of the traditional risk factors for breast cancer are themselves associated with mammographic breast density. A natural question that arises in this setting is the extent to which the effects of breast cancer risk factors are mediated by breast density and the extent to which such effects are through other pathways. We discuss analytic approaches to address these questions of mediation and also discuss how such approaches can accommodate potential interaction between risk factors and mammographic density and can accommodate case-control study designs.