Mammographic patterns in twin pairs discordant for breast cancer

As part of a case-control study of breast cancer in pairs of twins selected from the population-based Finnish Twin Cohort, mammograms of 30 pairs (seven monozygotic (MZ), 23 dizygotic (DZ] discordant for breast cancer were analysed. The mammographic pattern in the unaffected breast of the cancer case was compared with the pattern in the ipsilateral breast of the healthy twin (control). There were no differences for MZ pairs, while among DZ pairs the cancer case had a prominent parenchymal pattern significantly more often than the control, as assessed by two radiologists independently and blindly. Thus, there is a relationship between parenchymal pattern and risk of breast cancer even when the controls are the twin sisters of breast-cancer cases and are themselves at high risk. The overall similarity, despite disease discordance, in parenchymal pattern of the twins (more evident among MZ than DZ pairs) suggests a familial, possibly genetic influence on parenchymal pattern.