Hormonal Effects on Breast Density, Fibroglandular Tissue, and Back-ground Parenchymal Enhancement
Hormonal Effects on Breast Density, Fibroglandular Tissue, and Back-ground Parenchymal Enhancement
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DOI：
10.1148/rg.2018180035
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发表时间：
2018-07-01
期刊：
影响因子：
5.5
通讯作者：
Gao, Yiming
中科院分区：
文献类型：
--
作者：
Heller, Samantha L.;Lin, Leng Leng Young;Gao, Yiming
乳房密度、纤维腺组织和背景实质强化(BPE)是公认的乳腺癌风险的独立生物标志物。因此，在乳房X光检查(乳房密度)和磁共振成像(纤维腺组织和BPE)中客观评估这些参数的重复性和一致性具有临床意义。然而，乳房密度、纤维腺组织和BPE是动态生理过程的表现，可能会因内源性和外源性激素刺激而改变。因此，对于放射科医生来说，重要的是要认识到激素刺激可能会改变这些生物标记物在成像时的外观，并认识到这种变化可能会如何影响风险评估、癌症检测，甚至预后。因此，这篇综述文章的目的是回顾在影像上评估乳房密度、纤维腺组织和BPE的主要特征和方法；详细说明内源性和外源性激素刺激如何影响乳房密度、纤维腺组织和BPE，从而潜在地影响放射学解释；最后，提供关于当前激素治疗指南和可能通过激素调节导致影像变化的适应症的最新进展。(C)RSNA，2018年
Breast density, fibroglandular tissue, and background parenchymal enhancement (BPE) are recognized independent biomarkers for breast cancer risk. For this reason, reproducibility and consistency in objective assessment of these parameters at mammography (breast density) and at magnetic resonance imaging (fibroglandular tissue and BPE) are clinically relevant. However, breast density, fibroglandular tissue, and BPE are manifestations of dynamic physiologic processes and may change in response to both endogenous and exogenous hormonal stimulation. It is therefore important for the radiologist to recognize settings in which hormonal stimulation may alter the appearance of these biomarkers at imaging and to appreciate how such changes may affect risk assessment, cancer detection, and even prognosis. The purpose of this review article is therefore to review key features and means of evaluating breast density, fibroglandular tissue, and BPE at imaging; to detail how endogenous and exogenous hormonal stimuli may affect breast density, fibroglandular tissue, and BPE, potentially affecting radiologic interpretation; and, finally, to provide an update regarding current hormone treatment guidelines and indications that may result in imaging changes through hormone modulation. (C) RSNA, 2018