International Consortium on Mammographic Density:methodology and population diversity captured across 22 countries

Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether they are consistent across populations worldwide. We included 11755 women, from 27 studies in 22 countries, on whom individual-level risk factor data were pooled and original mammographic images were re-read for ICMD to obtain standardized comparable MD data. In the present article, we present (i) the rationale for this consortium; (ii) characteristics of the studies and women included; and (iii) study methodology to obtain comparable MD data from original re-read films. We also highlight the risk factor heterogeneity captured by such an effort and, thus, the unique insight the pooled study promises to offer through wider exposure ranges, different confounding structures and enhanced power for sub-group analyses

Mammographic density and ageing:A collaborative pooled analysis of cross-sectional data from 22 countries worldwide

BACKGROUND: Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known. METHODS AND FINDINGS: We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35-85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD) between post- and premenopausal women was apparent (-0.46 cm [95% CI: -0.53, -0.39]) and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2) was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was -0.24 cm (95% CI: -0.34, -0.14; I2 = 30%), reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area). In postmenopausal women, the corresponding difference in √PD (-0.38 cm [95% CI: -0.44, -0.33]; I2 = 30%) was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature. CONCLUSIONS: Declines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to women. If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction

Assessment of bone mineral density by dual x-ray absorptiometry in dermatological patients treated by corticosteroids

Background: Corticosteroids are mainstay of dermatological therapy and they are also a well known cause of osteoporosis. The objective of the present study was to find out the influence of the systemic intake of corticosteroids, either by the oral route or by IV pulse administration, on bone mineral density in dermatological patients using dual X-ray absorptiometry (DXA). Materials and Methods: This study was carried on 100 patients and 55 controls. The first group of patients included 55 patients undergoing long-term oral corticosteroid therapy daily and the second group included 45 patients who received IV dexamethasone pulse therapy. DXA was measured once for both the controls and patients in group 1. DXA was measured twice for patients in group 2, before starting pulse therapy (baseline DXA) and six months after regular treatment with pulse therapy (follow-up DXA). Results: The results show that significant reduction in BMD occurs in both groups, however, oral corticosteroids produce significantly more reduction in BMD in the lumbar spine. BMD was not found to be affected by the cumulative doses of corticosteroids, the duration of daily oral corticosteroid intake, or the number of IV dexamethasone pulses. Conclusion: Corticosteroid treatment causes significant BMD loss in patients treated by either route. Prophylactic treatment against osteoporosis is mandatory in patients receiving either form of corticosteroids

Role of MRI versus ultras

Purpose: To highlight the role of ultrasound (US) and magnetic resonance imaging (MRI) in detecting placental abnormalities and diseases. Patients and methods: This prospective study included fifty pregnant females with placental abnormalities (40 patients with abnormal placental location and/or implantation and 10 patients with other variable placental abnormalities). All the patients underwent US and MRI examination and detailed assessment of the placenta was performed. Operative findings, histopathology and/or follow-up were the gold standard for diagnosis in all cases. Results: The cases statistically evaluated in this study were gravid females with placenta previa at high risk of coexisting placental adhesive disorders (n = 39/50). The sensitivity and specificity of US were 68% and 78.57% respectively while those of MRI were 80% and 85.71% respectively in their ability to diagnose placental invasion. In placental hematoma cases, MRI confirmed the diagnosis due to the high sensitivity and specificity of MRI in detecting different ages of blood. In cases of molar pregnancy presence/absence of myometrial invasion was correctly detected in all cases by MRI. Conclusion: Magnetic resonance imaging is complementary to Ultrasound and it is important for the accurate diagnosis of placental abnormalities especially placenta previa and the seriously co-existing placenta accreta

The association of age at menarche and adult height with mammographic density in the International Consortium of Mammographic Density

Background Early age at menarche and tall stature are associated with increased breast cancer risk. We examined whether these associations were also positively associated with mammographic density, a strong marker of breast cancer risk. Methods Participants were 10,681 breast-cancer-free women from 22 countries in the International Consortium of Mammographic Density, each with centrally assessed mammographic density and a common set of epidemiologic data. Study periods for the 27 studies ranged from 1987 to 2014. Multi-level linear regression models estimated changes in square-root per cent density (√PD) and dense area (√DA) associated with age at menarche and adult height in pooled analyses and population-specific meta-analyses. Models were adjusted for age at mammogram, body mass index, menopausal status, hormone therapy use, mammography view and type, mammographic density assessor, parity and height/age at menarche. Results In pooled analyses, later age at menarche was associated with higher per cent density (β√PD = 0.023 SE = 0.008, P = 0.003) and larger dense area (β√DA = 0.032 SE = 0.010, P = 0.002). Taller women had larger dense area (β√DA = 0.069 SE = 0.028, P = 0.012) and higher per cent density (β√PD = 0.044, SE = 0.023, P = 0.054), although the observed effect on per cent density depended upon the adjustment used for body size. Similar overall effect estimates were observed in meta-analyses across population groups. Conclusions In one of the largest international studies to date, later age at menarche was positively associated with mammographic density. This is in contrast to its association with breast cancer risk, providing little evidence of mediation. Increased height was also positively associated with mammographic density, particularly dense area. These results suggest a complex relationship between growth and development, mammographic density and breast cancer risk. Future studies should evaluate the potential mediation of the breast cancer effects of taller stature through absolute breast density

Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide

Backgroun

Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems

Background: Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types

Pedagogical and psychological factors that influence player performance in youth football

Title: Psychological and pedagogical factors that influence player performance in youth football Objectives: The objective of the theoretical part is to analyze the psychological development of the player and the pedagogical aspects influencing the performance from the point of view of the educational activities of the coaches and parents. The selected theoretical starting points are then linked to the player's game play and its sporting development. The content of the research section is to examine the emotional reactions of the players of the preparatory and pupil categories in the clubs AC Sparta Praha and FK Dukla Praha. We analyzed the results of the emotional experience of the players and then we analyzed the differences of factors in the developmental stages of the sporting development and the results of the differences of emotional reactions of the players of both clubs. Methods: In this work we used a questioning method, namely a standardized DEMOR emotional reaction questionnaire examining emotional reactions of pupils. We have adapted it to the sport training environment and piloted. The research was conducted in seven teams of the AC Sparta Prague Football Club and seven teams of FK Dukla Prague in the U9-U15 category. Results: The results showed high values of positive emotional..

Modelled associations of square-root percent density, dense area, and total breast area with age and menopausal status, overall and by subgroups.

<p>Square-root dense/breast area is the width of a square representing the dense/breast area; square-root PD is the width of a dense-area square within a 10 cm × 10 cm square. All models are adjusted for age, BMI, BMI2, parity, age at first birth, HRT use (never, ever, past, current, not known), MD reader, image type, and mammography view. BMI, body mass index; CI, confidence interval; ICMD, International Consortium on Mammographic Density;HRT, hormone replacement therapy; MD, mammographic density.</p