Body fat distribution was studied in relation to mammographic breast morphology in a cross-sectional sample of 583 women aged 41-75 years participating in the DOM project, a regional breast cancer detection project in Utrecht, the Netherlands. The waist/hip ratio (WHR) was used as an indicator of body fat topography. Mammographic breast morphology was categorized according to the parenchymal breast patterns (N1, P1, P2, DY) as defined by Wolfe. Multivariate associations between the waist/hip ratio, Quetelet's index, age and parity and mammographic parenchymal patterns were tested by multiple linear logistic regression. Independently of age, parity and the degree of obesity, women with a high WHR ratio, i.e. with a predominant fat accumulation in the abdominal region, were significantly less likely to have the high risk P2, DY mammographic parenchymal pattern than women with a low WHR, i.e. with a preferential gluteal-femoral fat accumulation.