Localized fibroglandular tissue as a predictor of future tumor location within the breast.
Localized fibroglandular tissue as a predictor of future tumor location within the breast.
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DOI：
10.1158/1055-9965.epi-11-0423
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发表时间：
2011-08
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影响因子：
--
通讯作者：
dos-Santos-Silva I
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文献类型：
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作者：
Pinto Pereira SM;McCormack VA;Hipwell JH;Record C;Wilkinson LS;Moss SM;Hawkes DJ;dos-Santos-Silva I
乳腺摄影密度（MD）是乳腺癌风险的一个强有力的标志物，但目前还不清楚肿瘤是否专门发生在致密组织中。在231名英国女性中，在乳腺X线检查筛查试验中至少有一次阴性筛查后被诊断为乳腺癌，我们评估了肿瘤位置是否与诊断前5年的局部MD相关。放射科医生在数字化诊断片上确定肿瘤位置，并使用经过验证的算法来对齐同一名妇女的连续图像，以定位诊断前胶片上的相应点。将一个虚拟的1cm正方形网格覆盖在诊断前胶片上，并计算女性乳房内每个正方形的MD（平均值=271正方形/胶片）。条件Logistic回归，匹配一个女人的乳房，被用来估计的几率肿瘤出现在一个广场上的诊断前广场特定的MD。在随后包含肿瘤的1 cm正方形中，诊断前MD的中位数（四分位数间距）为98.2%（46.8%-100%），而在整个乳房中为41.0%（31.5%-53.9%）。在诊断前MD的第二、第三和第四分位数的乳房中，1 cm正方形内肿瘤发生的几率分别为6.1（95%CI：1.9，20.1）、16.6（5.2，53.2）和25.5倍（8.1，80.3）（P趋势<0.001）。如果使用3cm正方形网格，相应的比值为2.3（1.3，4.0），3.9（2.3，6.4）和4.6（2.8，7.6）。肿瘤主要发生在不透射线的乳腺组织内。局部MD可用作乳腺内后续肿瘤位置的预测因子。
Mammographic density (MD) is a strong marker of breast cancer risk, but it is unclear whether tumours arise specifically within dense tissue. In 231 British women diagnosed with breast cancer after at least one negative screen during a mammographic screening trial, we assessed whether tumour location was related to localised MD 5 years prior to diagnosis. Radiologists identified tumour locations on digitized diagnostic films and used a validated algorithm to align serial images from the same woman to locate the corresponding point on the pre-diagnostic film. A virtual 1cm-square grid was overlaid on pre-diagnostic films and MD calculated for each square within a woman’s breast (mean=271 squares/film). Conditional logistic regression, matching on a woman’s breast, was used to estimate the odds of a tumour arising in a square in relation to its pre-diagnostic square-specific MD. Median (inter-quartile range) pre-diagnostic MD was 98.2% (46.8%-100%) in 1cm-squares that subsequently contained the tumour and 41.0% (31.5%-53.9%) for the whole-breast. The odds of a tumour arising in a 1cm-square were, respectively, 6.1 (95%CI: 1.9, 20.1), 16.6 (5.2, 53.2) and 25.5-fold (8.1, 80.3) higher for squares in the 2nd, 3rd and 4th quartiles of pre-diagnostic MD relative to those in the lowest quartile within that breast (Ptrend<0.001). The corresponding odds were 2.3 (1.3, 4.0), 3.9 (2.3, 6.4) and 4.6 (2.8, 7.6) if a 3cm-square grid was used. Tumours arise predominantly within the radiodense breast tissue. Localised MD may be used as a predictor of subsequent tumour location within the breast.