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It is largely unknown how mammographic density is associated with breast cancer subtypes among Black women. We examined the association between percent mammographic density (PMD) and breast cancer risk among participants in the Black Women's Health Study. Digital screening mammograms were available for 363 cases and 5541 non\u2010cases. Cumulus software was used to assess PMD. We used inverse probability of sampling weights and Cox proportional hazards models, adjusted for age and body mass index, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) overall and by age at mammography and estrogen receptor (ER) status of the breast tumors. Multivariable models included additional breast cancer risk factors. Tests of statistical significance were 2\u2010sided. In simple models, women in the highest quartile of PMD had 53% increased odds of breast cancer compared to those in the lowest quartile (HR 1.53; 95% CI: 1.11, 2.11). HRs were 1.37 (95% CI: 0.83, 2.24) among women &lt;55\u2009years of age and 1.68 (95% CI: 1.10, 2.56) among women aged \u226555\u2009years. HRs were 1.49 (95% CI: 1.02, 2.16) for ER+ cancer and 1.45 (95% CI: 0.73, 2.87) for ER\u2013 cancer. Associations were largely unchanged in multivariable models. In this study of U.S. Black women, higher PMD was associated with ER+ and ER\u2013 breast cancer risk. Findings from this study reinforce the importance of breast density as a risk factor for breast cancer in Black women.<\/jats:p>","DOI":"10.1002\/ijc.35223","type":"journal-article","created":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T08:58:51Z","timestamp":1729328331000},"page":"1173-1180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Mammographic density and breast cancer risk among Black American women"],"prefix":"10.1002","volume":"156","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-9058","authenticated-orcid":false,"given":"Etienne X.","family":"Holder","sequence":"first","affiliation":[{"name":"Slone Epidemiology Center at Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahna","family":"Bigham","sequence":"additional","affiliation":[{"name":"Tufts University Graduate School of Biomedical Sciences  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerrie P.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mollie E.","family":"Barnard","sequence":"additional","affiliation":[{"name":"Slone Epidemiology Center at Boston University  Boston Massachusetts USA"},{"name":"Department of Medicine Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie R.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Slone Epidemiology Center at Boston University  Boston Massachusetts USA"},{"name":"Department of Medicine Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts 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