Mammographic density and risk of breast cancer by adiposity: an analysis of four case-control studies
Mammographic density and risk of breast cancer by adiposity: an analysis of four case-control studies
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DOI：
10.1002/ijc.26205
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发表时间：
2012-04-15
影响因子：
6.4
通讯作者：
Maskarinec, Gertraud
中科院分区：
文献类型：
--
作者：
Conroy, Shannon M.;Woolcott, Christy G.;Maskarinec, Gertraud
乳房 X 光检查乳腺密度与乳腺癌风险的关联可能因肥胖而异。为了检查体重指数（BMI）对效果的影响，作者对在加利福尼亚州、夏威夷州、明尼苏达州和日本岐阜县进行的四项病例对照研究（1994-2002）的乳房X光密度数据进行了标准化。 1,699 名病例和 2,422 名对照者包括 45% 的白人、40% 的亚洲人和 9% 的非洲裔美国人。使用特定种族的 BMI 切点，34% 的人被归类为超重，19% 的人被归类为肥胖。一名读者使用计算机辅助方法评估乳房 X 光图像的密度。 Logistic 回归用于估计比值比 (OR) 和 95% 置信区间 (95% CI)，同时调整潜在的混杂因素。不同研究中观察到密度百分比与乳腺癌风险之间的关系存在适度的异质性（p（异质性）= 0.08）。病例的年龄调整平均百分比密度高于对照组：分别为 31.7% 和 28.5% (p < 0.001)。 BMI 组中 35 岁的女性的情况相似，而 20-35 岁的超重女性 (OR = 1.69, 95% CI: 1.28, 2.24) 和肥胖 (OR = 1.62, 95% CI: 1.12, 2.33) 的 OR 略高于正常体重女性 (OR = 1.49, 95% CI: 1.11, 2.01)。此外，观察到百分比密度每增加 10%（p（交互作用）= 0.06），BMI 对 OR 的影响修正的证据有限，包括按绝经状态进行的亚组分析以及排除 BMI 极端女性的分析。我们的研究结果表明，体重指数对乳腺密度对乳腺癌风险影响的影响甚微（如果有的话）。
The association of mammographic breast density with breast cancer risk may vary by adiposity. To examine effect modification by body mass index (BMI), the authors standardized mammographic density data from four case-control studies (1994-2002) conducted in California, Hawaii and Minnesota and Gifu, Japan. The 1,699 cases and 2,422 controls included 45% Caucasians, 40% Asians and 9% African-Americans. Using ethnic-specific BMI cut points, 34% were classified as overweight and 19% as obese. A single reader assessed density from mammographic images using a computer-assisted method. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) while adjusting for potential confounders. Modest heterogeneity in the relation between percent density and breast cancer risk across studies was observed (p(heterogeneity) = 0.08). Cases had a greater age-adjusted mean percent density than controls: 31.7% versus 28.5%, respectively (p < 0.001). Relative to 35 were similar across BMI groups whereas the OR for 20-35 was slightly higher in overweight (OR = 1.69, 95% CI: 1.28, 2.24) and obese (OR = 1.62, 95% CI: 1.12, 2.33) than in normal weight women (OR = 1.49, 95% CI: 1.11, 2.01). Furthermore, limited evidence of effect modification by BMI of the OR per 10% increase in percent density (p(interaction) = 0.06) was observed, including subgroup analyses by menopausal status and in analyses that excluded women at the extremes of the BMI scale. Our findings indicate little, if any, modification by BMI of the effects of breast density on breast cancer risk.