Date of Award

January 2016

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Beth A. Jones

Second Advisor

Marcella Nunez-Smith

Abstract

Introduction: Breast density, the fibroglandular, non-fatty tissue in the breast, has been shown to be a significant risk factor for breast cancer. Little is currently known about the predictors of breast density among the understudied but increasing population of Hispanic and Latino women in the United States.

Objectives: The objective of this study is to identify predictors of breast density among Hispanic and Latino women in Connecticut and to determine if these differ from those described in other populations. Because the hormonal milieu is somewhat different in Hispanic/Latinas compared with White women, we are interested in how these variables impact breast density. We are primarily interested in the role of reproductive and physiological factors.

Methods: We analyzed for breast density predictors in an established cohort of 1,600 Hispanic and Latino women recruited from primary care clinics in Connecticut. Baseline interview questions provided prospective data on biological, medical care, and sociodemographic factors. Subjects provided informed consent for the retrieval of mammography reports from screening facilities during the follow-up period. These reports provided breast density information based on radiologist assigned BI-RADS classification. Associations between predictors and breast density were examined with descriptive statistics and chi square statistical tests for which p-values were reported. We additionally calculated odds ratios and 95% confidence intervals using logistic regression modeling.

Results: Breast density data were collected for 1,040 women (65.4%). 280 women (27%) were identified as having dense breasts while 760 women (73%) were classified as having nondense breasts based on screening mammogram reports. In the multivariate model, breast density predictors were generally consistent with those reported in previous studies. Additionally, we found women with diabetes to be at significantly reduced odds of breast density. There was also evidence that the relationship between age at menarche and density was modified by BMI.

Conclusion: Our findings suggest that Hispanic and Latino women differ in breast density distribution relative to the general population. Additionally, we observed the protective effect of diabetes and potential interaction between age at menarche and BMI. This investigation enhances our understanding of breast density in Hispanic and Latino women and provides the basis for further research and inquiry within this population.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/06/2018

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