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We aimed to develop a risk model for interval breast cancer. We conducted a nested case\u2013control study within the Melbourne Collaborative Cohort Study involving 168 interval breast cancer patients and 498 matched control subjects. We measured breast density using the CUMULUS software. We recorded first\u2010degree family history by questionnaire, measured body mass index (BMI) and calculated age\u2010adjusted breast tissue aging, a novel measure of exposure to estrogen and progesterone based on the Pike model. We fitted conditional logistic regression to estimate odds ratio (OR) or odds ratio per adjusted standard deviation (OPERA) and calculated the area under the receiver operating characteristic curve (AUC). The stronger risk associations were for unadjusted percent breast density (OPERA = 1.99; AUC = 0.66), more so after adjusting for age and BMI (OPERA = 2.26; AUC = 0.70), and for family history (OR = 2.70; AUC = 0.56). When the latter two factors and their multiplicative interactions with age\u2010adjusted breast tissue aging (<jats:italic>p<\/jats:italic> = 0.01 and 0.02, respectively) were fitted, the AUC was 0.73 (95% CI 0.69\u20130.77), equivalent to a ninefold interquartile risk ratio. In summary, compared with using dense breasts alone, risk discrimination for interval breast cancers could be doubled by instead using breast density, BMI, family history and hormonal exposure. This would also give women with dense breasts, and their physicians, more information about the major consequence of having dense breasts\u2014an increased risk of developing an interval breast cancer.<\/jats:p>","DOI":"10.1002\/ijc.32731","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T15:44:31Z","timestamp":1571067871000},"page":"375-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Interval breast cancer risk associations with breast density, family history and breast tissue aging"],"prefix":"10.1002","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6597-8363","authenticated-orcid":false,"given":"Tuong L.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health University of Melbourne  Parkville VIC 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