Understanding mammographic breast density profile in China: A Sino-Australian comparative study of breast density using real-world data from cancer screening programs.
Understanding mammographic breast density profile in China: A Sino-Australian comparative study of breast density using real-world data from cancer screening programs.
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了解中国乳房X线乳房密度的特征：使用癌症筛查计划中的现实世界数据对乳房密度进行中澳大利亚的比较研究。
DOI：
10.1111/ajco.13763
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发表时间：
2022-12
影响因子：
1.9
通讯作者：
Brennan, Patrick
中科院分区：
文献类型：
--
作者：
Li, Tong;Li, Jing;Heard, Rob;Gandomkar, Ziba;Ren, Jiansong;Dai, Min;Brennan, Patrick
本研究旨在通过比较中国与澳大利亚女性的乳房X光摄影密度，了解中国乳房X线摄影的密度分布情况。年龄在45-69岁的3,250名女性的数据来自中国市区癌症筛查项目，1,384名同龄澳大利亚同龄人的数据来自LifePool项目。收集了每个队列的人口统计和生殖细节以及乳房X光照片。使用AutoDensity评估乳腺X线密度，并应用百分比密度(PD)和致密面积(DA)两个指标。采用t检验比较绝经前妇女和绝经后妇女两组人群的平均乳房X线摄影密度。采用双因素方差分析检验群体(中国人/澳大利亚人)和每个感兴趣变量对乳腺X线摄影密度的交互作用。中国女性绝经前和绝经后的PD分别比澳大利亚女性高9.61%、8.20%和9.28%(P均<0.001)。绝经前和绝经后妇女的DA平均差值分别为1.81百万平方厘米(P<0.001)、0.55百万平方厘米(P=0.472)和1.76百万平方厘米(P=0.003)。年龄(F[4,4624])、体重指数(F[2,4628])、第一胎年龄(F[1,4250])、母乳喂养史(F[1,4479])、母乳喂养时间(F[1，0.001])、母乳喂养持续时间(F[1,3526])、母乳喂养持续时间(F[1,3526])、初产年龄(F[1,4250])、母乳喂养史(F[1,4479])、母乳喂养持续时间(F[1,3526])、母乳喂养持续时间(F[1,3526])、母乳喂养时间(F[1,356])、初产年龄(F[1,4250])、母乳喂养史(F[1,4479])、母乳喂养持续时间(F[1,3526])、母乳喂养持续时间(F[1,3526])、母乳喂养年限(F[1,3526])交互作用仅在DA的母乳喂养史(F[1,4479])和母乳喂养持续时间(F[1,3526])和母乳喂养持续时间(F[1,3526]F=17.72，P<0.001)之间存在交互作用。研究发现，与澳大利亚女性相比，中国女性的PD和DA都更高。不同绝经状态的乳房密度差异显著，母乳喂养史对乳房密度的影响也不同。人群与年龄、人群与BMI对乳腺摄影密度的交互作用被发现，这意味着年龄组和BMI类别对乳房密度的影响方式可能不同于中国女性，这表明人群在乳房密度变异中的异质性。
This study aims at understanding mammographic density profile in China by comparing the density between women in China and Australia. Data of 3250 women aged 45–69 were obtained from the Cancer Screening Program in Urban China and data of 1384 Australian counterparts at same age range were gathered from the Lifepool project. Demographic and reproductive details and mammograms for each cohort were collected. Mammographic density was assessed using AutoDensity, and two metrics, percentage density (PD) and dense area (DA), were applied. T‐tests were used to compare the means of mammographic density between two populations of all, premenopausal, and postmenopausal women. Two‐way ANOVA was conducted to examine interactions of population (Chinese/Australian) and each variable of interest upon mammographic density. Chinese women had 9.61%, 8.20%, and 9.28% higher PD than their Australian counterparts in all, premenopausal, and postmenopausal women, respectively (all p < 0.001). The mean differences in DA between two population were 1.81 cm2 (p < 0.001), 0.55 cm2 (p = 0.472), and 1.76 cm2 (p = 0.003) for all, premenopausal, and postmenopausal women, respectively. There were significant interactions between population and age (F[4, 4624] = 4.12, p = 0.003), BMI (F[2, 4628] = 3.92, p = 0.020), age at first birth (F[1, 4250] = 11.69, p < 0.001), breastfeeding history (F[1, 4479] = 17.79, p < 0.001), and breastfeeding duration (F[1, 3526] = 66.90, p < 0.001) upon PD. Interaction was only found for breastfeeding history (F[1, 4479] = 4.79, p = 0.029) and breastfeeding duration (F[1, 3526] = 17.72, p < 0.001) for DA. Both PD and DA were found to be higher in Chinese women compared to Australian women. The density difference by menopause status was shown and breastfeeding history affected breast density differently in both populations. Interaction effects between population and age, and between population and BMI, on mammographic density were found, meaning the ways in which age group and BMI category impact upon breast density in Australian women may not be the same as Chinese women, which suggested population heterogeneity in breast density variation.
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