Risk of breast cancer and changes in mammographic parenchymal patterns over time

The relationship between sequential mammographic parenchymal patterns and breast cancer was estimated and the results were applied to selective screening. In a pilot screening program 4163 Finnish women aged 40-47 years at entry were invited to be screened every second year from 1982 to 1990. Mammographic parenchymal patterns (Wolfe's classification) were recorded at each screening round. The follow-up ended in 1993 and up until that time 68 new breast cancers were diagnosed. The age-adjusted relative risk of breast cancer was 2.5 (95% CI 1.5-4.0) among women with high-risk mammographic parenchymal patterns (P2,DY) at the screenings preceding cancer diagnosis compared with those with low-risk patterns (N1,P1). After further adjustment for body mass index, number of pregnancies and size of the breast, the relative risk increased to 2.8 (95% CI 1.7-4.9). The mammographic parenchymal pattern is an independent risk factor of breast cancer but not strong enough to be used as a criterion for selective screening.