A prospective study of breast cancer risk using routine mammographic breast density measurements.
A prospective study of breast cancer risk using routine mammographic breast density measurements.
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DOI：
10.1158/1055-9965.715.13.5
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发表时间：
2004-05
期刊：
影响因子：
--
通讯作者：
P. Vacek;B. Geller
中科院分区：
文献类型：
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作者：
P. Vacek;B. Geller
乳房X光检查的乳房密度是乳腺癌的主要风险因素，但对不同密度模式相关的相对风险的估计存在很大差异。绝经状态如何影响这种联系，以及密度的影响在多大程度上与其他危险因素相关，目前还不清楚。最近对乳房密度的研究大多是病例对照研究，提供了相对风险的间接估计。我们前瞻性地对61,844名女性进行了平均3.1年的跟踪调查，以直接评估美国放射学会乳房成像报告和数据系统(BI-RADS)定义的四个乳房X光检查乳房密度类别中女性的风险。这项研究是以人群为基础的，使用了社区放射科医生常规进行的密度评估。使用COX回归获得年龄调整后的相对风险估计值，并对其他危险因素进行控制。风险随着密度的增加而增加，相对于完全肥胖的乳房，绝经前女性乳房过密的风险为4.6(95%可信区间，1.7-12.6)，绝经后女性为3.9(95%可信区间，2.6-5.8)。对绝经前和绝经后女性的估计没有显著差异。虽然乳房密度与体重指数、初次生育年龄和绝经后激素使用显著相关(P<；0.001)，但对这些变量的调整仅轻微改变了相对风险估计。我们的结果与病例对照研究中使用更多定量测量乳房密度的结果吻合得很好，并表明常规的乳房影像报告和数据系统密度测量在评估个别女性乳腺癌风险的模型中可能是有用的。
Mammographic breast density is a major risk factor for breast cancer but estimates of the relative risk associated with differing density patterns have varied widely. It is also unclear how menopausal status influences this association and to what extent the effects of density are due to its correlation with other risk factors. Most recent investigations of breast density have been case-control studies, which provide indirect estimates of relative risk. We have prospectively followed 61,844 women for an average of 3.1 years to directly estimate risk among women in the four mammographic breast density categories defined by the American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS). The study was population-based and used density assessments routinely made by community radiologists. Cox regression was used to obtain age-adjusted relative risk estimates and to control for other risk factors. Risk increased with density and the risk associated with extremely dense breasts, relative to entirely fatty breasts, was 4.6 (95% confidence interval, 1.7-12.6) for premenopausal women and 3.9 (95% confidence interval, 2.6-5.8) for postmenopausal women. Estimates for pre- and postmenopausal women did not differ significantly. Although breast density was significantly related to body mass index, age at first childbirth, and postmenopausal hormone use (P < 0.001), adjustment for these variables only slightly altered the relative risk estimates. Our results correspond well to those from case-control studies using more quantitative measures of mammographic breast density and suggest that routine Breast Imaging Reporting and Data System density measurements may be useful in models for assessing breast cancer risk in individual women.