{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:16:15Z","timestamp":1791688575910,"version":"4.3.4"},"reference-count":81,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In screening for breast cancer (BC), mammographic breast density (MBD) is a powerful risk factor that increases breast carcinogenesis and synergistically reduces the sensitivity of mammography. It also reduces specificity of lesion identification, leading to recalls, additional testing, and delayed and later-stage diagnoses, which result in increased health care costs. These findings provide the foundation for dense breast notification laws and lead to the increase in patient and provider interest in MBD. However, unlike other risk factors for BC, MBD is dynamic through a woman\u2019s lifetime and is modifiable. Although MBD is known to change as a result of factors such as reproductive history and hormonal status, few conclusions have been reached for lifestyle factors such as alcohol, diet, physical activity, smoking, body mass index (BMI), and some commonly used medications. Our review examines the emerging evidence for the association of modifiable factors on MBD and the influence of MBD on BC risk. There are clear associations between alcohol use and menopausal hormone therapy and increased MBD. Physical activity and the Mediterranean diet lower the risk of BC without significant effect on MBD. Although high BMI and smoking are known risk factors for BC, they have been found to decrease MBD. The influence of several other factors, including caffeine intake, nonhormonal medications, and vitamins, on MBD is unclear. We recommend counseling patients on these modifiable risk factors and using this knowledge to help with informed decision making for tailored BC prevention strategies.<\/jats:p>","DOI":"10.1093\/oncolo\/oyac084","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T11:14:21Z","timestamp":1649934861000},"page":"548-554","source":"Crossref","is-referenced-by-count":31,"title":["Association Between Lifestyle Changes, Mammographic Breast Density, and Breast Cancer"],"prefix":"10.1093","volume":"27","author":[{"given":"Sara P","family":"Lester","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic , Rochester, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna S","family":"Kaur","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic , Rochester, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneela","family":"Vegunta","sequence":"additional","affiliation":[{"name":"Division of Women\u2019s Health Internal Medicine, Mayo Clinic , Scottsdale, AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,10]]},"reference":[{"issue":"1","key":"2022070520470989700_CIT0001","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/mp.12683","article-title":"Deep learning method for classifying mammographic breast density categories","volume":"45","author":"Mohamed","year":"2018","journal-title":"Med Phys."},{"issue":"9","key":"2022070520470989700_CIT0002","first-page":"2058460118791212","article-title":"Density and tailored breast cancer screening: practice and prediction: an overview","volume":"7","author":"Wengert","year":"2018","journal-title":"Acta Radiol Open"},{"issue":"3","key":"2022070520470989700_CIT0003","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1186\/bcr2102","article-title":"Mammographic density: measurement of mammographic density","volume":"10","author":"Yaffe","year":"2008","journal-title":"Breast Cancer Res"},{"issue":"2","key":"2022070520470989700_CIT0004","first-page":"1358","article-title":"Measuring breast density: comparing computer-automated breast density quantification with an observer-based method in a South African academic context","volume":"22","author":"Prinsloo","year":"2018","journal-title":"SA J Radiol"},{"issue":"2","key":"2022070520470989700_CIT0005","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jacr.2018.08.009","article-title":"The impact of breast density reporting laws on women\u2019s awareness of density-associated risks and conversations regarding supplemental screening with providers","volume":"16","author":"Cappello","year":"2019","journal-title":"J Am Coll Radiol."},{"issue":"3","key":"2022070520470989700_CIT0006","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s10549-009-0496-9","article-title":"A prospective study of variability in mammographic density during the menstrual cycle","volume":"121","author":"Morrow","year":"2010","journal-title":"Breast Cancer Res Treat"},{"issue":"9","key":"2022070520470989700_CIT0007","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1158\/1055-9965.EPI-18-0151","article-title":"Volumetric mammographic density, age-related decline, and breast cancer risk factors in a national breast cancer screening program","volume":"27","author":"Hjerkind","year":"2018","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2022070520470989700_CIT0008","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41523-018-0055-9","article-title":"Breast cancer risk factors and mammographic density among high-risk women in urban China","volume":"4","author":"Sung","year":"2018","journal-title":"npj Breast Cancer"},{"issue":"1","key":"2022070520470989700_CIT0009","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.breast.2014.10.006","article-title":"Do pathological parameters differ with regard to breast density and mode of detection in breast cancer? 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