Investigating the prognostic value of mammographic breast density and mammographic tumor appearance in women with invasive breast cancer: The Malmo• Diet and cancer study

Background: High breast density is a risk factor for breast cancer. However, whether density is a prognostic factor is debatable. Also, tumor appearances are related to tumor characteristics. Here we investigate the relationship between breast cancer-specific survival and mammographic breast density and mammographic tumor appearances.Methods: Women in the Malmo center dot Diet and Cancer study with invasive breast cancer 1991-2014 were included (n = 1116). Mammographic information, patient and tumor characteristics, vital status, and causes of death were collected through 2018. Breast cancer-specific survival was assessed with Kaplan-Meier estimates and Cox proportional hazard models. Analyses were adjusted for established prognostic factors and stratified by detection mode.Results: High breast density did not significantly impact breast cancer-specific survival. However, there may be increased risk in women with dense breasts and screening-detected tumors (HR 1.45, CI 0.87-2.43). Neither did tumor appearance impact breast cancer-specific survival at long-term follow-up.Conclusions: Breast cancer prognosis in women with high breast density on mammography does not seem impaired compared to women with less dense breasts, once the cancer is established. Neither does mammo-graphic tumor appearance seem to inflict on prognosis, findings that can be of value in the management of breast cancer.