Prevalence of Women with Dense Breasts in Korea: Results from a Nationwide Cross-sectional Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Women with dense breast are known to be at high risk for breast cancer, but their prevalence and number of Korean women are unknown. The current study was to investigate the distribution of mammographic breast density by age of women undergoing screening mammography, and to estimate the prevalence of Korean women with dense breasts, quantitatively. MATERIALS AND METHODS: For obtaining a nationwide representative sample, 6,481 mammograms were collected from 86 screening units participated in the National Cancer Screening Program for breast cancer. Based on the American College of Radiology Breast Imaging Reporting and Data System classification, breast density was evaluated by six breast radiologists, qualitatively. We applied these breast density distributions to age-specific counts of the Korean women population derived to mid-year 2017 to estimate the number of Korean women with dense breasts. RESULTS: Overall, 54.4% (95% confidence interval [CI], 52.9% to 55.8%) of women 40 to 69 years of age had heterogeneously or extremely dense breasts, and this proportion was inversely associated with age. Based on the age distribution of Korean women, we estimated that 6,083,000 women (95% CI, 5,919,600 to 6,245,600) age 40-69 years in Korean have dense breasts. Women aged 40-49 years (n=3,450,000) accounted for 56.7% of this group. CONCLUSION: More than half of Korean women aged 40 and over have dense breasts. To prevent breast cancer effectively and efficiently, it is necessary to develop a new personalized prevention strategy considering her status of breast density.

Analysis of Participant Factors That Affect the Diagnostic Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea

OBJECTIVE: To analyze participant factors that affect the diagnostic performance of screening mammography. MATERIALS AND METHODS: We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables. RESULTS: Increasing age improved recall rates (27.4% in 40's, 17.5% in 50's, 11.1% in 60's, and 8.6% in 70's), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001). CONCLUSION: Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance.

Urinary concentration of 3-phenoxybenzoic acid in elementary students in South Korea

OBJECTIVES: Pyrethroid pesticides are among the most commonly using insecticides in South Korean households and have been the subject of considerable interest among public health professionals for their potential health effects. The objective of this study is to examine the level of urinary 3-phenoxybenzoic acid (3-PBA) among elementary students in South Korea. METHODS: We conducted a cross-sectional study to evaluate pyrethroid pesticide exposure levels by measuring the urinary metabolites of 3-PBA using a gas chromatography-mass spectrometry method in March 2011. Study participants were 70 Asan-area and Incheon-area elementary students. RESULTS: All respondents had values above the detection limit, and the geometric means of 3-PBA in all children were 1.85 μg/L and 1.46 μg/g creatinine. Children with the top 10% urinary levels of 3-PBA were more likely to be girls, under nine years of age, living in a rural area, and living in a residential type apartment. CONCLUSIONS: South Korean children have a higher concentration of urinary 3-PBA compared with those of other countries. Further research identifying exposure pathways and intervention efforts to reduce environmental pesticide use are needed in South Korea.

Urinary concentration of 3-phenoxybenzoic acid in elementary students in South Korea

OBJECTIVES: Pyrethroid pesticides are among the most commonly using insecticides in South Korean households and have been the subject of considerable interest among public health professionals for their potential health effects. The objective of this study is to examine the level of urinary 3-phenoxybenzoic acid (3-PBA) among elementary students in South Korea. METHODS: We conducted a cross-sectional study to evaluate pyrethroid pesticide exposure levels by measuring the urinary metabolites of 3-PBA using a gas chromatography-mass spectrometry method in March 2011. Study participants were 70 Asan-area and Incheon-area elementary students. RESULTS: All respondents had values above the detection limit, and the geometric means of 3-PBA in all children were 1.85 μg/L and 1.46 μg/g creatinine. Children with the top 10% urinary levels of 3-PBA were more likely to be girls, under nine years of age, living in a rural area, and living in a residential type apartment. CONCLUSIONS: South Korean children have a higher concentration of urinary 3-PBA compared with those of other countries. Further research identifying exposure pathways and intervention efforts to reduce environmental pesticide use are needed in South Korea.