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Mammographic density MD is considered a strong predictor of Breast Cancer BC. The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research WCRF-AICR recommendations for cancer prevention.


Data of 3584 women attending screening from a population-based multicenter cross-sectional study DDM-Spain collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF-AICR recommendations: R1Maintain adequate body weight; R2Be physically active; 3RLimit the intake of high density foods; R4Eat mostly plant foods; R5Limit the intake of animal foods; R6Limit alcohol intake; R7Limit salt and salt preserved food intake; R8Meet nutritional needs through diet. The association between the score and MD assessed by a single radiologist using a semi-quantitative scale was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out.


A higher compliance with the WCRF-AICR recommendations was associated with lower MD OR1-unit increase = 0.93 95%CI:0.86;0.99. The association was stronger in postmenopausal women OR = 0.91 95%CI:0.84;0.99 and nonsmokers OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042. Among nonsmokers, maintaining adequate body weight OR = 0.81 95%CI:0.65;1.01, practicing physical activity OR = 0.68 95%CI:0.48;0.96 and moderating the intake of high-density foods OR = 0.58 95%CI:0.40;0.86 and alcoholic beverages OR = 0.76 95%CI:0.55;1.05 were the recommendations showing the strongest associations with MD.


postmenopausal women and non-smokers with greater compliance with the WCRF-AICR guidelines have lower MD. These results may provide guidance to design specific recommendations for screening attendants with high MD and therefore at higher risk of developing BC.

Autor: Adela Castelló , Leandro Prieto, María Ederra, Dolores Salas-Trejo, Carmen Vidal, Carmen Sánchez-Contador, Carmen Santamariña



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