Longitudinal measurement of clinical mammographic breast density to improve estimation of breast cancer risk
Longitudinal measurement of clinical mammographic breast density to improve estimation of breast cancer risk
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DOI：
10.1093/jnci/djk066
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发表时间：
2007-03-07
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影响因子：
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通讯作者：
Ballard-Barbash, Rachel
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作者：
Kerlikowske, Karla;Ichikawa, Laura;Ballard-Barbash, Rachel
临床测量的乳腺密度随时间的变化是否会影响乳腺癌风险尚不清楚。方法从1993年1月至2003年12月，前瞻性收集301955名30岁及以上未使用绝经后激素替代治疗且至少接受过两次筛查性乳房x光检查的女性的资料，包括美国放射学会乳腺影像学报告和数据系统（BI-RADS）乳腺密度分类（1-4按密度递增顺序排列）；2639名妇女在最后一次检查后一年内被诊断为乳腺癌。女性首次和最后一次BI-RADS乳房密度（平均间隔3.2年）和逻辑回归用于通过BI-RADS类别的变化来模拟在最后一次检查后12个月内诊断为浸润性乳腺癌或导管原位癌的几率。根据年龄、乳房x光检查登记和筛查检查间隔时间调整后的乳腺癌发病率从该模型中估计出来。所有统计检验均为双侧检验。结果当BI-RADS乳腺密度类别从1增加到2（5.6,95%可信区间[CI] = 4.7 ~ 6.9）或从1增加到3 （9.9,95% Cl = 6.4 ~ 15.5）时，乳腺癌的发生率（每1000名妇女中乳腺癌的发生率）高于BI-RADS密度类别为1时(3.0,95% Cl = 2.3 ~ 3.9
Background Whether a change over time in clinically measured mammographic breast density influences breast cancer risk is unknown.Methods From January 1993 to December 2003, data that included American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) breast density categories (1-4 in order of increasing density) were collected prospectively on 301955 women aged 30 and older who were not using postmenopausal hormone replacement therapy and underwent at least two screening mammography examinations; 2639 of the women were diagnosed with breast cancer within 1 year of the last examination. Women's first and last BI-RADS breast density (average 3.2 years apart) and logistic regression were used to model the odds of having invasive breast cancer or ductal carcinoma in situ diagnosed within 12 months of the last examination by change in BI-RADS category. Rates of breast cancer adjusted for age, mammography registry, and time between screening examinations were estimated from this model. All statistical tests were two-sided.Results The rate (breast cancers per 1000 women) of breast cancer was higher if BI-RADS breast density category increased from 1 to 2 (5.6, 95% confidence interval [CI] = 4.7 to 6.9) or 1 to 3 (9.9, 95% Cl = 6.4 to 15.5) compared to when it remained at BI-RADS density of 1 (3.0, 95% Cl = 2.3 to 3.9; P