Mammographic density and hormone receptor expression in breast cancer: The Multiethnic Cohort Study
Mammographic density and hormone receptor expression in breast cancer: The Multiethnic Cohort Study
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DOI：
10.1016/j.canep.2010.11.011
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发表时间：
2011-10-01
影响因子：
2.6
通讯作者：
Maskarinec, Gertraud
中科院分区：
文献类型：
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作者：
Conroy, Shannon M.;Pagano, Ian;Maskarinec, Gertraud
背景资料：目前尚不清楚乳房X光检查乳腺密度（乳腺癌的一个强危险因素）是否可以预测由雌激素受体（ER）和/或孕激素受体（PR）表达定义的乳腺癌亚型。研究方法：在一项巢式病例对照研究中，我们比较了多种族队列研究中夏威夷白人、日本人和夏威夷原住民血统的667例对照和607例乳腺癌患者的乳腺密度。对疾病状态不知情的阅片者对诊断前乳房X线片进行计算机辅助密度评估。受体状态从全州夏威夷肿瘤登记处获得。肿瘤分为ER+PR+（n = 341）、ER-PR（n = 50）、ER+PR-/ER-PR+（n = 64）和未分期/未知（n = 152）。平均百分比密度值计算的妇女与一个以上的乳房X线照片。多分类logistic回归用于估计比值比（OR）和95%置信区间（CI），同时调整混杂因素。结果如下：校正年龄后，与对照组相比，ER+PR+肿瘤的平均百分比密度显著更高，但ER-PR-肿瘤的平均百分比密度则无显著差异：分别为37.3%、28.9%和29.4%。ER+PR+和ER+PR-/ER-PR+肿瘤的密度百分比每增加10%的总体OR相似：分别为1.26（95% CI 1.17-1.36）和1.23（95% CI 1.07-1.42）。然而，未发现百分比密度是ER-PR肿瘤的预测因素（OR 1.00，95%CI 0.84-1.18）。结果没有不同的种族，也没有绝经状态，奇偶校验，或HRT的使用。结论：我们的研究结果表明，在多种族人群中，乳腺密度较高的女性患ER+PR+肿瘤的风险增加，而不是ER-PR-肿瘤。(C)2010爱思唯尔有限公司版权所有。
Background: It is unclear whether mammographic breast density, a strong risk factor for breast cancer, predicts subtypes of breast cancer defined by estrogen receptor (ER) and/or progesterone receptor (PR) expression. Methods: In a nested case-control study, we compared the breast density of 667 controls and 607 breast cancer cases among women of Caucasian, Japanese, and Native Hawaiian ancestry in the Hawaii component of the Multiethnic Cohort Study. A reader blinded to disease status performed computer assisted density assessment on prediagnostic mammograms. Receptor status was obtained from the statewide Hawaii Tumor Registry. Tumors were classified into ER+PR+ (n = 341), ER-PR(n = 50), ER+PR-/ER-PR+ (n = 64), and unstaged/unknown (n = 152). Mean percent density values were computed for women with more than one mammogram. Polytomous logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) while adjusting for confounders. Results: Mean percent density was significantly greater for ER+PR+ but not for ER-PR- tumors compared to controls after adjusting for age: 37.3%, 28.9% versus 29.4%, respectively. The overall OR per 10% increase in percent density were similar for ER+PR+ and ER+PR-/ER-PR+ tumors: 1.26 (95% CI 1.17-1.36) and 1.23 (95% CI 1.07-1.42), respectively. However, percent density was not found to be a predictor for ER-PR- tumors (OR 1.00,95% CI 0.84-1.18). The results did not differ by ethnicity, nor by menopausal status, parity, or HRT use. Conclusions: Our findings indicate that within a multiethnic population, women with higher breast density have an increased risk for ER+PR+ but not ER-PR- tumors. (C) 2010 Elsevier Ltd. All rights reserved.