Breast Cancer Characteristics Associated With Digital Versus Film-Screen Mammography for Screen-Detected and Interval Cancers
Breast Cancer Characteristics Associated With Digital Versus Film-Screen Mammography for Screen-Detected and Interval Cancers
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DOI：
10.2214/ajr.14.13904
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发表时间：
2015-09-01
影响因子：
5
通讯作者：
Lehman, Constance D.
中科院分区：
文献类型：
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作者：
Henderson, Louise M.;Miglioretti, Diana L.;Lehman, Constance D.
OBJECTIVE.本研究的目的是确定数字乳腺X线摄影与胶片乳腺X线摄影在筛查和间隔期乳腺癌的病理结果是否不同。回顾了2003-2011年乳腺癌监测联盟对4089岁女性的3，021，515次筛查乳房X线照片（40.3%数字，59.7%胶片）的数据。如果在检查后12个月内诊断为阳性结果，则认为筛查检出癌症，如果在检查后12个月内诊断为阴性结果，则认为筛查检出癌症。使用logistic回归模型比较数字与胶片乳腺X射线摄影的筛查和间隔期癌症的肿瘤特征，以估计比值比和95% CI，并调整年龄、人种和种族、激素治疗使用、筛查间隔、检查年份和登记。广义估计方程用于解释设施内的相关性。在15，729例乳腺癌中，85.3%是筛查发现的，14.7%是间歇性的。数字和胶片乳房X线摄影的屏幕检测率（每1000次检查4.47 vs 4.42）和间隔（每1000次检查0.73 vs 0.79）数字与胶片癌症相似。在校正分析中，在手指检查阴性结果后诊断的间隔癌症不太可能是美国癌症联合委员会IIB期或更高（比值比，0.69; 95% CI，0.52-0.93），具有阳性淋巴结状态（比值比，0.78; 95%CI，0.64-0.95），或雌激素受体阴性（比值比，0.71; 95%CI，0.56-0.91）。在数字和胶片乳腺X射线摄影后诊断的屏幕检测癌症具有相似的不利肿瘤特征率。在数字检查后诊断的间隔检测的癌症比在胶片乳房X线摄影后诊断的癌症具有不利的肿瘤特征的可能性更小，但绝对差异很小。
OBJECTIVE. The purpose of this study was to determine whether pathologic findings of screen-detected and interval cancers differ for digital versus film mammography.MATERIALS AND METHODS. Breast Cancer Surveillance Consortium data from 2003-2011 on 3,021,515 screening mammograms (40.3% digital, 59.7% film) of women 4089 years old were reviewed. Cancers were considered screen detected if diagnosed within 12 months of an examination with positive findings and interval if diagnosed within 12 months of an examination with negative findings. Tumor characteristics for screen-detected and interval cancers were compared for digital versus film mammography by use of logistic regression models to estimate the odds ratio and 95% CI with adjustment for age, race and ethnicity, hormone therapy use, screening interval, examination year, and registry. Generalized estimating equations were used to account for correlation within facilities.RESULTS. Among 15,729 breast cancers, 85.3% were screen detected and 14.7% were interval. Digital and film mammography had similar rates of screen-detected (4.47 vs 4.42 per 1000 examinations) and interval (0.73 vs 0.79 per 1000 examinations) cancers for digital versus film. In adjusted analyses, interval cancers diagnosed after digital examinations with negative findings were less likely to be American Joint Committee on Cancer stage IIB or higher (odds ratio, 0.69; 95% CI, 0.52-0.93), have positive nodal status (odds ratio, 0.78; 95% CI, 0.64-0.95), or be estrogen receptor negative (odds ratio, 0.71; 95% CI, 0.56-0.91) than were interval cancers diagnosed after a film examination with negative findings.CONCLUSION. Screen-detected cancers diagnosed after digital and film mammography had similar rates of unfavorable tumor characteristics. Interval-detected cancers diagnosed after a digital examination were less likely to have unfavorable tumor features than those diagnosed after film mammography, but the absolute differences were small.