Overeating, caloric restriction and mammographic density in Spanish women. DDM-Spain study

[EN] Objectives: Mammographic density (MD) is a strong risk factor for breast cancer. The present study evaluates the association between relative caloric intake and MD in Spanish women. Study design: We conducted a cross-sectional study in which 3517 women were recruited from seven breast cancer screening centers. MD was measured by an experienced radiologist using craniocaudal mammography and Boyd's semi-quantitative scale. Information was collected through an epidemiological survey. Predicted calories were calculated using linear regression models, including the basal metabolic rate and physical activity as explanatory variables. Overeating and caloric restriction were defined taking into account the 99% confidence interval of the predicted value. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using center-specific mixed ordinal logistic regression models, adjusted for age, menopausal status, body mass index, parity, tobacco use, family history of breast cancer, previous biopsies, age at menarche and adherence to a Western diet. Main outcome measure: Mammographic density. Results: Those women with an excessive caloric intake ( > 40% above predicted) presented higher MD (OR = 1.41, 95%CI = 0.97-2.03; p = 0.070). For every 20% increase in relative caloric consumption the probability of having higher MD increased by 5% (OR = 1.05, 95%CI = 0.98-1.14; p = 0.178), not observing differences between the categories of explanatory variables. Caloric restriction was not associated with MD in our study. Conclusions: This is the first study exploring the association between MD and the effect of caloric deficit or excessive caloric consumption according to the energy requirements of each woman. Although caloric restriction does not seem to affect breast density, a caloric intake above predicted levels seems to increase this phenotypeThis study was supported by the Research Grant FIS PI060386 from Spanish Public Health Research Fund (Fondo de Investigacion Sanitaria); the Carlos III Institute of Health (Institute de Salud Carlos III)PI15CIII/0029 and PI15CIII/00013; the EPY 1306/06Collaboration Agreement between Astra-Zeneca and the Carlos III Institute of Health; and a grant from the Spanish Federation of Breast Cancer Patients (FECMA EPY 1169/10).Del Pozo, MDP.; Castelló, A.; Vidal, C.; Salas -Trejo, D.; Sanchez Contador, C.; Pedraz-Pingarrón, C.; Moreno, MP.... (2018). Overeating, caloric restriction and mammographic density in Spanish women. DDM-Spain study. Maturitas. 117:57-63. https://doi.org/10.1016/j.maturitas.2018.09.006S576311

High mammographic density in long-term night shift workers: DDM-Spain /Var-DDM

[EN] Background: Night-shift work (NSW) has been suggested as a possible cause of breast cancer, and its association with mammographic density (MD), one of the strongest risk factors for breast cancer, has been scarcely addressed. This study examined NSW and MD in Spanish women. Methods: The study covered 2,752 women aged 45-68 years recruited in 2007-2008 in 7 population-based public breast cancer screening centers, which included 243 women who had performed NSW for at least one year. Occupational data and information on potential confounders were collected by personal interview. Two trained radiologist estimated the percentage of MD assisted by a validated semiautomatic computer tool (DM-scan). Multivariable mixed linear regression models with random screening center-specific intercepts were fitted using log-transformed percentage of MD as the dependent variable and adjusting by known confounding variables. Results: Having ever worked in NSW was not associated with MD [e(beta):0.96; 95% confidence interval (CI), 0.86-1.06]. However, the adjusted geometric mean of the percentage of MD in women with NSW for more than 15 years was 25% higher than that of those without NSW history (MD>15 (years):20.7% vs. MDnever:16.5%; e(beta):1.25; 95% CI, 1.01-1.54). This association was mainly observed in postmenopausal participants (e(beta):1.28; 95% CI, 1.00-1.64). Among NSW-exposed women, those with <= 2 night-shifts per week had higher MD than those with 5 to 7 nightshifts per week (e(beta):1.42; 95% CI, 1.10-1.84). Conclusions: Performing NSW was associated with higherMD only in women with more than 15 years of cumulated exposure. These findings warrant replication in futures studies. (C)2017 AACR.We would like to thank the participants in the DDM-Spain/Var-DDM-Spain study for their contribution to breast cancer research. Other members of DDM-Spain/Var-DDM: Gonzalo. López-Abente, Roberto Pastor-Barriuso, Pablo Fernández-Navarro, Anna Cabanes, Soledad Laso, Manuela Alcaraz, María Casals, Inmaculada Martínez, Juan Carlos Pérez Cortés, Joaquín Antón, Nieves Ascunce, Isabel González-Román, Ana Belén Fernández, Montserrat Corujo, Soledad Abad, and Jesús Vioque. A.M. Pedraza-Flechas FI14CIII/00013 PFIS; B. Perez-Gomez FIS PS09/0790; M. Pollán FIS PI060386, EPY1306/06 collaboration agreement between Astra-Zeneca and ISCIII, and FECMA 485 EPY 1170 10; R. LLobet Gent per Gent Fund (EDEMAC Project); All authors: European Regional Development Fund (FEDER). The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.Pedraza-Flechas, AM.; Lope, V.; Sanchez-Contador, C.; Santamarina, C.; Pedraz-Pingarron, C.; Moreo, P.; Ederra, M.... (2017). High mammographic density in long-term night shift workers: DDM-Spain /Var-DDM. Cancer Epidemiology Biomarkers & Prevention. 26(6):905-913. https://doi.org/10.1158/1055-9965.EPI-16-0507S90591326

Sleep patterns, sleep disorders and mammographic density in spanish women: The DDM-Spain/Var-DDM study

[EN] We explored the relationship between sleep patterns and sleep disorders and mammographic density (MD), a marker of breast cancer risk. Participants in the DDM-Spain/var-DDM study, which included 2878 middle-aged Spanish women, were interviewed via telephone and asked questions on sleep characteristics. Two radiologists assessed MD in their left craneo-caudal mammogram, assisted by a validated semiautomatic-computer tool (DM-scan). We used log-transformed percentage MD as the dependent variable and fitted mixed linear regression models, including known confounding variables. Our results showed that neither sleeping patterns nor sleep disorders were associated with MD. However, women with frequent changes in their bedtime due to anxiety or depression had higher MD (e¿:1.53;95%CI:1.04¿2.26).This work was supported by grants from the Spanish Ministry of Economy and Competitiveness - Carlos III Institute of Health (ISCIII) (FI14CIII/00013, FIS PI060386 & PS09/0790), from the Spanish Federation of Breast Cancer Patients (FECMA 485 EPY 1170-10), Gent per Gent Fund (EDEMAC Project), the EPY1306/06 collaboration agreement between Astra-Zeneca and the ISCIII and partially funded by the European Regional Development Fund (FEDER)Pedraza-Flechas, AM.; Lope, V.; Moreo, P.; Ascunce, N.; Miranda-García, J.; Vidal, C.; Sánchez-Contador, C.... (2017). Sleep patterns, sleep disorders and mammographic density in spanish women: The DDM-Spain/Var-DDM study. Maturitas. 99:105-108. https://doi.org/10.1016/j.maturitas.2017.02.015S1051089

El tractament anticoagulant oral en els pacients de l’ICS: recomanacions en el procés d’atenció de les persones malaltes amb tractament anticoagulant amb fàrmacs antivitamina K de l’Institut Català de la Salut

Tractament anticoagulant oral; Fàrmacs antivitamina K; Serveis d'hematologia; Atenció primàriaTratamiento anticoagulante oral; Fármacos antivitamina K; Servicios de hematología; Atención primariaOral anticoagulant treatment; Anti-vitamin K drugs; Hematology services; Primary careAquest document pretén proposar recomanacions per millorar la qualitat donada als pacients i percebuda pels pacients i els professionals sanitaris en relació amb el tractament anticoagulant amb fàrmacs antivitamina K. També vol millorar l’accessibilitat per apropar el control dels pacients als serveis sanitaris; promoure elements de coordinació entre l’atenció primària i l’hospital per adequarla a les necessitats sanitàries del i la pacient; integrar una aplicació específica per al maneig del tractament anticoagulant amb AVK a la història compartida de Catalunya (HCCC) per tal de poder-se utilitzar des dels diferents punts d’atenció (primària i hospitalària); i, finalment, estendre el tractament a totes les persones que se’n poden beneficiar: actualment moltes persones tenen una fibril·lació auricular que no els ha estat diagnosticada, i, d’altra banda, pacients amb una indicació de tractament anticoagulant no reben tractament

El tractament anticoagulant oral en els pacients de l’ICS: recomanacions en el procés d’atenció de les persones malaltes amb tractament anticoagulant amb fàrmacs antivitamina K de l’Institut Català de la Salut

Tractament anticoagulant oral; Fàrmacs antivitamina K; Serveis d'hematologia; Atenció primàriaTratamiento anticoagulante oral; Fármacos antivitamina K; Servicios de hematología; Atención primariaOral anticoagulant treatment; Anti-vitamin K drugs; Hematology services; Primary careAquest document pretén proposar recomanacions per millorar la qualitat donada als pacients i percebuda pels pacients i els professionals sanitaris en relació amb el tractament anticoagulant amb fàrmacs antivitamina K. També vol millorar l’accessibilitat per apropar el control dels pacients als serveis sanitaris; promoure elements de coordinació entre l’atenció primària i l’hospital per adequarla a les necessitats sanitàries del i la pacient; integrar una aplicació específica per al maneig del tractament anticoagulant amb AVK a la història compartida de Catalunya (HCCC) per tal de poder-se utilitzar des dels diferents punts d’atenció (primària i hospitalària); i, finalment, estendre el tractament a totes les persones que se’n poden beneficiar: actualment moltes persones tenen una fibril·lació auricular que no els ha estat diagnosticada, i, d’altra banda, pacients amb una indicació de tractament anticoagulant no reben tractament

Residential proximity to industrial pollution and mammographic density

[EN] Background: Mammographic density (MD), expressed as percentage of fibroglandular breast tissue, is an important risk factor for breast cancer. Our objective is to investigate the relationship between MD and residential proximity to pol-lutant industries in premenopausal Spanish women. MeOds: A cross-sectional study was carried out in a sample of 1225 women extracted from the DDM-Madrid study. Multiple linear regression models were used to assess the association of MD percentage (and their 95% confidence in-tervals (95%CIs)) and proximity (between 1 km and 3 km) to industries included in the European Pollutant Release and Transfer Register. Results: Although no association was found between MD and distance to all industries as a whole, several industrial sectors showed significant association for some distances: "surface treatment of metals and plastic" (j3 = 4.98, 95%CI = (0.85; 9.12) at <_1.5 km, and j3 = 3.00, 95%CI = (0.26; 5.73) at <_2.5 km), "organic chemical industry" (j3 = 6.73, 95%CI = (0.50; 12.97) at <_1.5 km), "pharmaceutical products" (j3 = 4.14, 95%CI = (0.58; 7.70) at <_2 km; j3 = 3.55, 95%CI = (0.49; 6.60) at <_2.5 km; and j3 = 3.11, 95%CI = (0.20; 6.01) at <_3 km), and "urban waste-water treatment plants" (j3 = 8.06, 95%CI = (0.82; 15.30) at <_1 km; j3 = 5.28; 95%CI = (0.49; 10.06) at <_1.5 km; j3 = 4.30, 95%CI = (0.03; 8.57) at <_2 km; j3 = 5.26, 95%CI = (1.83; 8.68) at <_2.5 km; and j3 = 3.19, 95%CI = (0.46; 5.92) at <_3 km). Moreover, significant increased MD was observed in women close to industries releasing specific pollutants: ammonia (j3 = 4.55, 95%CI = (0.26; 8.83) at <_1.5 km; and j3 = 3.81, 95%CI = (0.49; 7.14) at <_2 km), dichloromethane (j3 = 3.86, 95%CI = (0.00; 7.71) at <_2 km), ethylbenzene (j3 = 8.96, 95%CI = (0.57; 17.35) at <_3 km), and phenols (j3 = 2.60, 95%CI = (0.21; 5.00) at <_2.5 km). Conclusions: Our results suggest no statistically significant relationship between MD and proximity to industries as a whole, although we detected associations with various industrial sectors and some specific pollutants, which suggests that MD could have a mediating role in breast carcinogenesis.We would like to thank the participants in the DDM-Madrid study for their contribution to breast cancer research. This work was supported by the Carlos III Institute of Health (AESI PI15CIII/0029, AESI PI15CIII/00013, and EPY-505/19-PFIS) . The article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health.Jiménez, T.; Pollán, M.; Domínguez-Castillo, A.; Lucas, P.; Sierra, MÁ.; Fernández De Larrea-Baz, N.; González-Sánchez, M.... (2022). Residential proximity to industrial pollution and mammographic density. Science of The Total Environment. 829:1-11. https://doi.org/10.1016/j.scitotenv.2022.15457811182

Occupation, occupational exposures and mammographic density in Spanish women

[EN] Introduction: Mammographic density (MD), the proportion of radiologically dense breast tissue, is a strong risk factor for breast cancer. Our objective is to investigate the influence of occupations and occupational exposure to physical, chemical, and microbiological agents on MD in Spanish premenopausal women. Methods: This is a cross-sectional study based on 1362 premenopausal workers, aged 39-50, who attended a gynecological screening in a breast radiodiagnosis unit of Madrid City Council. The work history was compiled through a personal interview. Exposure to occupational agents was evaluated using the Spanish job-exposure matrix MatEmESp. MD percentage was assessed using the validated semi-automated computer tool DM-Scan. The association between occupation, occupational exposures, and MD was quantified using multiple linear regression models, adjusted for age, educational level, body mass index, parity, previous breast biopsies, family history of breast cancer, energy intake, use of oral contraceptives, smoking, and alcohol consumption. Results: Although no occupation was statistically significantly associated with MD, a borderline significant inverse association was mainly observed in orchard, greenhouse, nursery, and garden workers (beta = -6.60; 95% confidence interval (95%CI) = -14.27; 1.07) and information and communication technology technicians (beta = -7.27; 95%CI = -15.37; 0.84). On the contrary, a positive association was found among technicians in art galleries, museums, and libraries (beta = 8.47; 95%CI = -0.65; 17.60). Women occupationally exposed to fungicides, herbicides, and insecticides tended to have lower MD. The percentage of density decreased by almost 2% for every 5 years spent in occupations exposed to the mentioned agents. Conclusions: Although our findings point to a lack of association with the occupations and exposures analyzed, this study supports a deeper exploration of the role of certain occupational agents in MD, such as pesticides.This work was supported by the Carlos III Institute of Health (AESI PI15CIII/00029 and AESI PI15CIII/00013). The article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health.Jiménez, T.; Garcia-Perez, J.; Van Der Haar, R.; Alba, MÁ.; Lucas, P.; Sierra, MÁ.; Fernández De Larrea-Baz, N.... (2021). Occupation, occupational exposures and mammographic density in Spanish women. Environmental Research. 195:1-9. https://doi.org/10.1016/j.envres.2021.110816S1919