Mammographic Breast Density of Japanese Women Living in Australia: Implications for Breast Screening Policy

Background: Mammographic Breast Density (MBD) increases breast cancer risk, lowers sensitivity of mammography and is related to ethnicity. This study compared the MBD of Australian women living in Australia (AW), Japanese women living in Japan (JWJ) and Japan-born women living in Australia (JWA). The outcomes have implications for breast screening policies in Australia. Methods: In this cross-sectional study, mammographic images were collected from a total of 677 women who were examined at BreastScreen NSW or Miyata Hospital, Japan. The images were retrospectively evaluated using the 5th edition Breast Imaging-Reporting and Data System (BI-RADS) to assess the level of MBD. Descriptive analyses and binary logistic regressions were performed. Results: More than 65% of AW had low MBD while the majority of JWJ had high MBD. Among AW, low MBD was found in women aged 40-49 and 50-59. The MBD of JWA showed a similar pattern to JWJ but with a slightly lower MBD. The great majority of JWA aged 40-49 were found to have high MBD compared to women aged 50-59. JWJ were categorised as high MBD regardless of their age. JWA were 5 times more likely and JWJ were 15 times more likely to have high MBD compared to AW. Conclusion: Mammography screening becomes more effective for JW after migration to Australia. For JWA aged 40-49 years, supplemental screening options are indicated to provide better cancer detection. For AW, screening mammography could be equally as effective for AW aged 40-49 years as for those aged 50-59.