Thyroid disorders and mammographic density in Spanish women: Var-DDM study

Objectives The association between breast cancer (BC) and thyroid disorders has been widely explored with unclear results. Mammographic density (MD) is one of the strongest risk factor for BC. This study explores the relationship between thyroid diseases and MD in Spanish women. Materials & methods This cross-sectional study covered 2883 women aged 47–71 years participating in 7 BC screening programs in 2010. They allowed access to their mammograms, had anthropometrical-measures taken, and answered a telephonic epidemiological interview which included specific questions on thyroid diseases. Percentage of MD was assessed with a semiautomatic-computer tool (DM-scan) by two trained radiologists. We calculated the geometric mean of MD percentages (mean MD). Multivariable mixed linear regression models with random screening-center-specific intercepts were fitted, using log-transformed percentage of MD as dependent variable and adjusting for age, body mass index, menopausal status and other confounders. e^β represents the relative increase of mean MD. Results 13.9% of the participants reported personal history of thyroid disease. MD was not associated to hyperthyroidism (e^β:1.05, 95%CI: 0.82–1.36), hypothyroidism (e^β:1.02, 95%CI: 0.75–1.38), thyroid nodules (e^β:1.01, 95%CI: 0.85–1.19) or thyroid cancer (e^β:1.03, 95%CI: 0.56–1.92). However, women with goiter had lower MD (mean MD_no-goiter: 13.4% vs mean MD_goiter: 10.6%; e^β:0.79, 95%CI: 0.64–0.98) and those with Hashimoto thyroiditis had higher MD (mean MD_{no-thyroiditis}: 13.3% vs mean MD_thyroidits: 25.8%; e^β:1.94, 95%CI: 1.00–3.77). Conclusion Functional thyroid disorders were not related to MD. However, MD was lower in women with goiter and higher in those reporting Hashimoto's thyroiditis. These relationships should be confirmed in future studies.