ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2013
Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 2 of them syntheses that pooled it.
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Who cites it
71 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mammographic density, endocrine therapy and breast cancer risk: a prognostic and predictive biomarker review.The Cochrane database of systematic reviews · 2021Pooled it
- Relationship Between Breast Density and Selective Estrogen-Receptor Modulators, Aromatase Inhibitors, Physical Activity, and Diet: A Systematic Review.Integrative cancer therapies · 2016Pooled it
- Endoxifen for mammographic density reduction-results from the KARISMA endoxifen trial.Journal of the National Cancer Institute · 2026Trial
- Influence of endoxifen on mammographic density: results from the KARISMA-Tam trial.Journal of the National Cancer Institute · 2025Trial
- Low-dose tamoxifen treatment reduces collagen organisation indicative of tissue stiffness in the normal breast: results from the KARISMA randomised controlled trial.Breast cancer research : BCR · 2024Trial
- Topical Endoxifen for Mammographic Density Reduction-A Randomized Controlled Trial.The oncologist · 2022Trial
- Low-Dose Tamoxifen for Mammographic Density Reduction: A Randomized Controlled Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Trial
- Stiff stroma increases breast cancer risk by inducing the oncogene ZNF217.The Journal of clinical investigation · 2020Trial
- Area and volumetric density estimation in processed full-field digital mammograms for risk assessment of breast cancer.PloS one · 2014Trial
- Aromatase inhibitor-induced modulation of breast density: clinical and genetic effects.British journal of cancer · 2013Trial
- Change in mammographic density as a potential predictor of cancer recurrence after breast conservation surgery and adjuvant endocrine therapy: results of the MEDICI study.Breast cancer research : BCR · 2026Article
- Breast density and risk of breast cancer: masking and detection bias.American journal of epidemiology · 2025Article
- Estradiol and testosterone associated with risk of breast cancer: A meta-analysis.Journal of medical biochemistry · 2024Article
- Mammographic Breast Density at Breast Cancer Diagnosis and Breast Cancer-Specific Survival.Diagnostics (Basel, Switzerland) · 2024Article
- Breast percent density changes in digital mammography pre- and post-radiotherapy.Journal of medical radiation sciences · 2024Article
- Review
- Bone mineral density fall during aromatase inhibitor treatment may predict lower breast cancer recurrence.Cancer medicine · 2024Article
- Lifetime changes in body fatness and breast density in postmenopausal women: the FEDRA study.Breast cancer research : BCR · 2023Article
- Short-term changes in ultrasound tomography measures of breast density and treatment-associated endocrine symptoms after tamoxifen therapy.NPJ breast cancer · 2023Article
- Mammographic density in relation to breast cancer recurrence and survival in women receiving neoadjuvant chemotherapy.Frontiers in oncology · 2023Article
11 more citing papers are in PubMed but not listed here.
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTamoxifen treatment is associated with a reduction in mammographic density and an improved survival. However, the extent to which change in mammographic density during adjuvant tamoxifen therapy can be used to measure response to treatment is unknown. PATIENTS AND
methodsOverall, 974 postmenopausal patients with breast cancer who had both a baseline and a follow-up mammogram were eligible for analysis. On the basis of treatment information abstracted from medical records, 474 patients received tamoxifen treatment and 500 did not. Mammographic density was measured by using an automated thresholding method and expressed as absolute dense area. Change in mammographic density was calculated as percentage change from baseline. Survival analysis was performed by using delayed-entry Cox proportional hazards regression models, with death as a result of breast cancer as the end point. Analyses were adjusted for a range of patient and tumor characteristics.
resultsDuring a 15-year follow-up, 121 patients (12.4%) died from breast cancer. Women treated with tamoxifen who experienced a relative density reduction of more than 20% between baseline and first follow-up mammogram had a reduced risk of death as a result of breast cancer of 50% (hazard ratio, 0.50; 95% CI, 0.27 to 0.93) compared with women with stable mammographic density. In the no-tamoxifen group, there was no statistically significant association between mammographic density change and survival. The survival advantage was not observed when absolute dense areas at baseline or follow-up were evaluated separately.
conclusionA decrease in mammographic density after breast cancer diagnosis appears to serve as a prognostic marker for improved long-term survival in patients receiving adjuvant tamoxifen, and these data should be externally validated.
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