High Mammographic Density in Long-Term Night-Shift Workers: DDM-Spain/Var-DDM

Ana María Pedraza-Flechas, Virginia Lope, Carmen Sánchez-Contador, Carmen Santamariña, Carmen Pedraz-Pingarrón, Pilar Moreo, María Ederra, Josefa Miranda-García, Carmen Vidal, Rafael Llobet, Nuria Aragonés, Dolores Salas-Trejo, Marina Pollán, Beatriz Pérez-Gómez

Background:Night-shift work (NSW) has been suggested as a possible cause of breast cancer (BC), and its association with mammographic density (MD), one of the strongest risk factors for BC, has been scarcely addressed. This study examined NSW and MD in Spanish women. Methods:The study covered 2752 women aged 45-68 years recruited in 2007-2008 in 7 population-based public BC screening centers, which included 243 women who had performed NSW for at least one year. Occupational data and information on potential confounders was 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(β):0.96; 95%CI:0.86-1.06). However, the adjusted geometric mean of the percentage of MD in women with NSW for more than15 years was 25% higher than that of those without NSW history (MD>15 years:20.7% vs MDnever:16.5%;e^β:1.25; 95%CI:1.01-1.54). This association was mainly observed in postmenopausal participants (e(β):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 5-7 nightshifts per week (e(β):1.42; 95%CI:1.10-1.84). Conclusions:Performing NSW was associated with higher MD only in women with more than 15 years of cumulated exposure. These findings warrant replication in futures studies. Impact:Our findings suggest that MD could play a role in the pathway between long term NSW and BC.