The effects of menopausal vasomotor symptoms and changes in anthropometry on breast cancer etiology

The effects of menopausal vasomotor symptoms and changes in anthropometry on breast cancer etiology" (2015). opportunities that he has provided for me throughout this process. I am also indebted to our collaborators at the SWAN and BCSC facilities for their interest in and efforts towards this research. encouragement, and their belief in my success. I am more than grateful for everything you have given me. Finally, I would like to thank my friend family-you know who you are-for the many miles, many bottles of wine, and many moments of support. This would not have been possible without you. Much about the etiology of breast cancer remains unknown. One of the strongest predictors of breast cancer risk is mammographic density; however, the mechanisms relating density to breast cancer risk are not fully understood and this has limited the use of mammographic density as a marker for breast cancer susceptibility. Hormone fluctuations during the menopausal transition may influence declines in mammographic density and may also trigger the onset of menopausal vasomotor symptoms (VMS), which have been associated with lower breast cancer risk. The effects of hormone changes on density, VMS, and ultimately breast cancer risk are complicated by external factors such as changing body mass and exogenous hormone therapy use during the menopausal transition. We evaluated the longitudinal association between change in BMI and change in breast density among 24,556 women in the Breast Cancer Surveillance Consortium using a novel volumetric measurement method. We found that an annual increase in BMI was associated with a decrease in both absolute dense volume (β=-1.01 cm 3 , 95% CI-1.59,-0.42) and in percent dense volume (β=-1.17%, 95% CI-1.31,-1.04). Longitudinal studies of density and breast cancer, or those using density to reflect breast cancer risk, should thus consider controlling for BMI gain/loss to understand the independent relationship between density and risk. We further vi investigated the association of VMS and percent mammographic density (PMD) among 833 women enrolled Study of Women's Health Across the Nation (SWAN) Mammographic Density Sub-study. We observed no overall association between VMS and PMD (β =-0.47%, 95% CI-1.39, 0.45), although some evidence of an inverse association was found among perimenopausal women (β =-1.29%, 95% CI-2.58,-0.001) and those using hormone therapy (β =-3.62%, 95% CI-7.17,-0.07). These results suggest that an association between VMS and breast cancer risk is via a pathway that is not strongly mediated by changes in breast density. Finally, we …