Mammographic density change in a cohort of premenopausal women receiving tamoxifen for breast cancer prevention over 5 years.
Mammographic density change in a cohort of premenopausal women receiving tamoxifen for breast cancer prevention over 5 years.
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DOI：
10.1186/s13058-020-01340-4
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发表时间：
2020-09-29
期刊：
影响因子：
--
通讯作者：
Howell A
中科院分区：
文献类型：
--
作者：
Brentnall AR;Warren R;Harkness EF;Astley SM;Wiseman J;Fox J;Fox L;Eriksson M;Hall P;Cuzick J;Evans DG;Howell A
他莫昔芬预防性治疗导致的乳房密度降低可能表明该药物有更大的益处。目前尚不清楚乳房X光检查密度在治疗1年后是否继续下降，也不知道乳房密度变化的测量是否足够稳定，可用于个性化建议。在英国曼彻斯特的一家家族病史诊所就诊的绝经前妇女(2010-2013年基线)，对绝经前无乳腺癌诊断但乳腺癌风险增加的妇女，在长达5年的时间里每年测量乳房X光摄影密度。其中一组服用预防用他莫昔芬(20 mg/d)，疗程长达5年；另一组未服用他莫昔芬，年龄匹配。在5年的随访中，对乳房X线片使用了全自动方法：三种基于区域的测量(NN-VAS，Stratus，Densitas)和一种体积测量(Volpara)。此外，在基线和第一次随访时的乳房密度百分比被目测测量。密度的大小在第一次随访乳房X光检查时下降，此后使用根据年龄和体重指数调整的线性混合模型进行估计。根据1年个体密度变化或平均密度变化，通过估计预测的均方误差损失来评价1年密度变化的稳定性。分析使用了126名健康的绝经前妇女和她们接受三苯氧胺预防治疗时的乳房X光检查(中位年龄42岁)和172名匹配的对照组(中位年龄41岁)，并进行了中位3年的随访。在服用他莫昔芬和不服用他莫昔芬的两组患者中，同一乳房X光片使用的百分比密度测量之间有很强的相关性(所有相关系数均为0.8)。他莫昔芬在第一年将平均乳房密度降低了大约17-25%，这是基线时四个自动百分比密度测量的四分位数之间的范围，从第二年开始，每年进一步降低大约2-7%。使用1年的个体变化预测2年后的变化比使用1年的平均变化预测差约60%-300%。所有测量结果都显示，在第一年期间，他莫昔芬引起的密度变化一致且幅度较大，此后继续下降。然而，这些密度变化的指标在1年的个体基础上并不稳定。
A decrease in breast density due to tamoxifen preventive therapy might indicate greater benefit from the drug. It is not known whether mammographic density continues to decline after 1 year of therapy, or whether measures of breast density change are sufficiently stable for personalised recommendations. Mammographic density was measured annually over up to 5 years in premenopausal women with no previous diagnosis of breast cancer but at increased risk of breast cancer attending a family-history clinic in Manchester, UK (baseline 2010-2013). Tamoxifen (20 mg/day) for prevention was prescribed for up to 5 years in one group; the other group did not receive tamoxifen and were matched by age. Fully automatic methods were used on mammograms over the 5-year follow-up: three area-based measures (NN-VAS, Stratus, Densitas) and one volumetric (Volpara). Additionally, percentage breast density at baseline and first follow-up mammograms was measured visually. The size of density declines at the first follow-up mammogram and thereafter was estimated using a linear mixed model adjusted for age and body mass index. The stability of density change at 1 year was assessed by evaluating mean squared error loss from predictions based on individual or mean density change at 1 year. Analysis used mammograms from 126 healthy premenopausal women before and as they received tamoxifen for prevention (median age 42 years) and 172 matched controls (median age 41 years), with median 3 years follow-up. There was a strong correlation between percentage density measures used on the same mammogram in both the tamoxifen and no tamoxifen groups (all correlation coeficients > 0.8). Tamoxifen reduced mean breast density in year 1 by approximately 17–25% of the inter-quartile range of four automated percentage density measures at baseline, and from year 2, it decreased further by approximately 2–7% per year. Predicting change at 2 years using individual change at 1 year was approximately 60–300% worse than using mean change at 1year. All measures showed a consistent and large average tamoxifen-induced change in density over the first year, and a continued decline thereafter. However, these measures of density change at 1 year were not stable on an individual basis.
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影响因子：
3.8
作者：
Ko, Kyung Lan;Shin, In Suk;Lee, Eun Sook
通讯作者：
Lee, Eun Sook
影响因子：
10.3
作者：
Nyante, Sarah J.;Sherman, Mark E.;Gierach, Gretchen L.
通讯作者：
Gierach, Gretchen L.
影响因子：
168.9
作者：
Davies, C.;Godwin, J.;Gray, R.;Clarke, M.;Darby, S.;McGale, P.;Wang, Y. C.;Peto, R.;Pan, H. C.;Cutter, D.;Taylor, C.;Ingle, J.
通讯作者：
Ingle, J.
DOI：
10.1093/jnci/djr079
发表时间：
2011-05-01
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Cuzick, Jack;Warwick, Jane;Warren, Ruth M. L.
通讯作者：
Warren, Ruth M. L.
影响因子：
2.4
作者：
Ionescu, Georgia, V;Fergie, Martin;Astley, Susan M.
通讯作者：
Astley, Susan M.