Biomarkers of mammographic density in premenopausal women

Breast Cancer Res. 2021 Jul 23;23(1):75. doi: 10.1186/s13058-021-01454-3.


Background: While mammographic density is one of the strongest risk factors for breast cancer, little is known about its determinants, especially in young women. We applied targeted metabolomics to identify circulating metabolites specifically associated with mammographic density in premenopausal women. Then, we aimed to identify potential correlates of these biomarkers to guide future research on potential modifiable determinants of mammographic density.

Methods: A total of 132 metabolites (acylcarnitines, amino acids, biogenic amines, glycerophospholipids, sphingolipids, hexose) were measured by tandem liquid chromatography/mass spectrometry in plasma samples from 573 premenopausal participants in the Mexican Teachers' Cohort. Associations between metabolites and percent mammographic density were assessed using linear regression models, adjusting for breast cancer risk factors and accounting for multiple tests. Mean concentrations of metabolites associated with percent mammographic density were estimated across levels of several lifestyle and metabolic factors.

Results: Sphingomyelin (SM) C16:1 and phosphatidylcholine (PC) ae C30:2 were inversely associated with percent mammographic density after correction for multiple tests. Linear trends with percent mammographic density were observed for SM C16:1 only in women with body mass index (BMI) below the median (27.4) and for PC ae C30:2 in women with a BMI over the median. SM C16:1 and PC ae C30:2 concentrations were positively associated with cholesterol (total and HDL) and inversely associated with number of metabolic syndrome components.

Conclusions: We identified new biomarkers associated with mammographic density in young women. The association of these biomarkers with mammographic density and metabolic parameters may provide new perspectives to support future preventive actions for breast cancer.

Keywords: Mammographic density; Mexican women; Premenopausal; Targeted metabolomics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Body Mass Index
  • Breast / diagnostic imaging
  • Breast Density / physiology*
  • Breast Neoplasms / blood
  • Breast Neoplasms / diagnostic imaging
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Mammography
  • Metabolomics
  • Mexico
  • Middle Aged
  • Phosphatidylcholines / blood
  • Premenopause*
  • Risk Factors
  • Sphingomyelins / blood


  • Biomarkers
  • Phosphatidylcholines
  • Sphingomyelins
  • Cholesterol