Marnmographic breast density as a general marker of breast cancer risk
Marnmographic breast density as a general marker of breast cancer risk
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DOI：
10.1158/1055-9965.epi-06-0738
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发表时间：
2007-01-01
影响因子：
3.8
通讯作者：
Sellers, Thomas A.
中科院分区：
文献类型：
--
作者：
Vachon, Celine M.;Brandt, Kathleen R.;Sellers, Thomas A.
乳房 X 光检查乳腺密度是乳腺癌的一个重要危险因素，但乳腺密度是否是易感性的一般标志，还是特定于最终癌症的位置尚不清楚。在 Mayo Clinic 乳房 X 线摄影筛查实践中对 372 例乳腺癌病例和 713 例匹配对照进行了研究。乳腺癌发生前平均 7 年的乳房 X 光检查被数字化，并估计了每侧和视图的百分比密度和致密面积的定量测量值。根据两个乳房X线照片视图计算占总体密度百分比的区域密度估计值。从医疗记录中提取乳腺癌的位置和潜在的混杂因素。条件逻辑回归用于估计关联性，C 统计量用于评估风险预测的强度。随着百分比密度和致密面积四分位数的增加，乳腺癌风险呈增加趋势，无论乳腺癌的一侧如何（P 趋势 < 0.001）。同侧的百分比密度 [颅尾 (CC)：比值比 (OR)、1.0（参考）、1.7、3.1 和 3.1；内侧斜肌 (MLO)：ORs，1.0（参考）、1.5、2.2 和 2.8] 和对侧 [CC：ORs，1.0（参考）、1.8、2.2 和 3.7； MLO：OR，1.0（参考）、1.6、1.9 和 2.5）类似地预测病例对照状态（C 统计量，0.64-65）。考虑到总体密度百分比，随后发生癌症的区域的密度并不是一个显着的危险因素[CC：1.0（参考）、1.3、1.0 和 1.2； MLO：1.0（参考）、1.1、1.0 和 1.1（用于增加四分位数）]。平均在癌症发生前 3 年检查乳房 X 光照片时，结果没有变化。总体乳房X线照相密度似乎代表了乳腺癌风险的一般标志，该标志并不特定于最终癌症的乳侧或位置。
Mammographic breast density is a strong risk factor for breast cancer but whether breast density is a general marker of susceptibility or is specific to the location of the eventual cancer is unknown. A study of 372 incident breast cancer cases and 713 matched controls was conducted within the Mayo Clinic mammography screening practice. Mammograms on average 7 years before breast cancer were digitized, and quantitative measures of percentage density and dense area from each side and view were estimated. A regional density estimate accounting for overall percentage density was calculated from both mammogram views. Location of breast cancer and potential confounders were abstracted from medical records. Conditional logistic regression was used to estimate associations, and C-statistics were used to evaluate the strength of risk prediction. There were increasing trends in breast cancer risk with increasing quartiles of percentage density and dense area, irrespective of the side of the breast with cancer (P-trend < 0.001). Percentage density from the ipsilateral side [craniocaudal (CC): odds ratios (ORs), 1.0 (ref), 1.7, 3.1, and 3.1; mediolateral oblique (MLO): ORs, 1.0 (ref), 1.5, 2.2, and 2.8] and the contralateral side [CC: ORs, 1.0 (ref), 1.8, 2.2, and 3.7; MLO: ORs, 1.0 (ref), 1.6, 1.9, and 2.5) similarly predicted case-control status (C-statistics, 0.64-65). Accounting for overall percentage density, density in the region where the cancer subsequently developed was not a significant risk factor [CC: 1.0 (ref), 1.3, 1.0, and 1.2; MLO: 1.0 (ref), 1.1, 1.0, and 1.1 for increasing quartiles]. Results did not change when examining mammograms 3 years on average before the cancer. Overall mammographic density seems to represent a general marker of breast cancer risk that is not specific to breast side or location of the eventual cancer.