Celestino Sardu1, Gianluca Gatta2, Gorizio Pieretti3, Luigi Viola4, Cosimo Sacra5, Graziella Di Grezia6, Lanfranco Musto6, Salvatore Minelli7, Daniele La Forgia8, Mariangela Capodieci9, Alessandro Galiano9, Angela Vestito10, Angela De Lisio11, Pia Clara Pafundi12, Ferdinando Carlo Sasso12, Salvatore Cappabianca2, Gianfranco Nicoletti13, Giuseppe Paolisso12, Raffaele Marfella12. 1. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy. Electronic address: drsarducele@gmail.com. 2. Breast Unit, Department of Clinical and Experimental Internship, University of Campania "Luigi Vanvitelli," Naples, Italy; Department of Imaging, University of Naples, Naples, Italy. 3. Breast Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Naples, Naples, Italy. 4. Breast Unit, Department of Clinical and Experimental Internship, University of Campania "Luigi Vanvitelli," Naples, Italy. 5. Department of Cardiovascular Diseases, "John Paul II" Research and Care Foundation, Campobasso, Italy. 6. Department of Imaging, "Criscuoli" Hospital, Avellino, Italy. 7. Department of Imaging, "Antonio Cardarelli" Hospital, Naples, Italy. 8. IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy. 9. Department of Imaging, Hospital of Brindisi, Italy. 10. Department of Imaging, "Saint Paul" Hospital, Bari, Italy. 11. Department of Imaging, "Federico II" University of Naples, Italy. 12. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy. 13. Department of Imaging, University of Naples, Naples, Italy; Breast Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Naples, Naples, Italy.
Abstract
OBJECTIVES: This study sought to determine whether the breast gland adipose tissue is associated with different rates of major adverse cardiac events (MACEs) in pre-menopausal women. BACKGROUND: To our knowledge, no study investigated the impact of breast adipose tissue infiltration on MACEs in pre-menopausal women. METHODS: Prospective multicenter cohort study conducted on pre-menopausal women >40 years of age without cardiovascular disease and breast cancer at enrollment. The study started in January 2000 and ended in January 2009, and the end of the follow-up for the evaluation of MACEs was in January 2019. Participants underwent mammography to evaluate breast density and were divided into 4 groups according to their breast density. The primary endpoint was the probability of a MACE at 10 years of follow-up in patients staged for different breast deposition/adipose tissue deposition. RESULTS: The propensity score matching divided the baseline population of 16,763 pre-menopausal women, leaving 3,272 women according to the category of breast density from A to D. These women were assigned to 4 groups of the study according to baseline breast density. At 10 years of follow-up, we had 160 MACEs in group 1, 62 MACEs in group 2, 27 MACEs in group 3, and 16 MACEs in group 4. MACEs were predicted by the initial diagnosis of lowest breast density (hazard ratio: 3.483; 95% confidence interval: 1.476 to 8.257). Further randomized clinical trials are needed to translate the results of the present study into clinical practice. The loss of ex vivo breast density models to study the cellular/molecular pathways implied in MACE is another study limitation. CONCLUSIONS: Among pre-menopausal women, a higher evidence of adipose tissue at the level of breast gland (lowest breast density, category A) versus higher breast density shows higher rates of MACEs. Therefore, the screening mammography could be proposed in overweight women to stage breast density and to predict MACEs. (Breast Density in Pre-menopausal Women Is Predictive of Cardiovascular Outcomes at 10 Years of Follow-Up [BRECARD]; NCT03779217).
OBJECTIVES: This study sought to determine whether the breast gland adipose tissue is associated with different rates of major adverse cardiac events (MACEs) in pre-menopausal women. BACKGROUND: To our knowledge, no study investigated the impact of breast adipose tissue infiltration on MACEs in pre-menopausal women. METHODS: Prospective multicenter cohort study conducted on pre-menopausal women >40 years of age without cardiovascular disease and breast cancer at enrollment. The study started in January 2000 and ended in January 2009, and the end of the follow-up for the evaluation of MACEs was in January 2019. Participants underwent mammography to evaluate breast density and were divided into 4 groups according to their breast density. The primary endpoint was the probability of a MACE at 10 years of follow-up in patients staged for different breast deposition/adipose tissue deposition. RESULTS: The propensity score matching divided the baseline population of 16,763 pre-menopausal women, leaving 3,272 women according to the category of breast density from A to D. These women were assigned to 4 groups of the study according to baseline breast density. At 10 years of follow-up, we had 160 MACEs in group 1, 62 MACEs in group 2, 27 MACEs in group 3, and 16 MACEs in group 4. MACEs were predicted by the initial diagnosis of lowest breast density (hazard ratio: 3.483; 95% confidence interval: 1.476 to 8.257). Further randomized clinical trials are needed to translate the results of the present study into clinical practice. The loss of ex vivo breast density models to study the cellular/molecular pathways implied in MACE is another study limitation. CONCLUSIONS: Among pre-menopausal women, a higher evidence of adipose tissue at the level of breast gland (lowest breast density, category A) versus higher breast density shows higher rates of MACEs. Therefore, the screening mammography could be proposed in overweight women to stage breast density and to predict MACEs. (Breast Density in Pre-menopausal Women Is Predictive of Cardiovascular Outcomes at 10 Years of Follow-Up [BRECARD]; NCT03779217).
Authors: Egidio Imbalzano; Giuseppina T Russo; Annalisa Giandalia; Angela Sciacqua; Luana Orlando; Vincenzo Russo; Maria Perticone; Arrigo F G Cicero; Antonio Giovanni Versace; Pierpaolo Di Micco; Vincenzo Antonio Ciconte; Giuseppe Dattilo; Giovanni Squadrito; Marco Vatrano Journal: Biomedicines Date: 2022-02-10
Authors: Anna D'Angelo; Gianluca Gatta; Graziella Di Grezia; Sara Mercogliano; Francesca Ferrara; Charlotte Marguerite Lucille Trombadori; Antonio Franco; Alessandro Cina; Paolo Belli; Riccardo Manfredi Journal: Tomography Date: 2022-08-12