Mammographic density and histopathologic characteristics of screen-detected tumors in the Norwegian Breast Cancer Screening Program
Mammographic density and histopathologic characteristics of screen-detected tumors in the Norwegian Breast Cancer Screening Program
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DOI：
10.1177/2058460115604340
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发表时间：
2015-09-01
影响因子：
1.1
通讯作者：
Hofvind, Solveig
中科院分区：
文献类型：
--
作者：
Moshina, Nataliia;Ursin, Giske;Hofvind, Solveig
背景资料：乳腺钼靶摄影高密度可能掩盖乳腺肿瘤，导致延误诊断或漏诊。目的：探讨乳腺钼靶摄影高密度与肿瘤病理组织学特征的关系（组织学类型、大小、等级和淋巴结状态）。材料和方法：分析了1996-2010年在50-69岁女性中诊断的1760例筛查发现的导管原位癌（DCIS）和7366例浸润性乳腺癌的信息。由乳腺放射科医生根据纤维腺体组织的数量将筛查性乳腺X线片主观地分为脂肪、中等密度和致密。采用卡方检验比较乳腺钼靶摄影密度分布的肿瘤特征。密度的肿瘤特征的优势比（OR）估计通过logistic回归，调整筛选模式（屏幕电影和全视野数字乳腺摄影），和age.Results：平均值和中位数的浸润性乳腺癌的肿瘤大小分别为13.8和12毫米，脂肪乳腺的妇女，和16.2和14毫米的致密乳腺。脂肪性乳腺组淋巴结阳性率为20.6%，致密性乳腺组为27.2%（P < 0.001）。脂肪性乳腺的DCIS发生率（15.8%）明显低于致密性乳腺（22.0%）。与脂肪和中等密度乳腺相比，高密度乳腺患者发生大肿瘤（OR，1.44; 95% CI，1.18-1.73）和淋巴结阳性肿瘤（OR，1.26; 95% CI，1.05-1.51）的风险增加。
Background: High mammographic density might mask breast tumors, resulting in delayed diagnosis or missed cancers.Purpose: To investigate the association between mammographic density and histopathologic tumor characteristics (histologic type, size, grade, and lymph node status) among women screened in the Norwegian Breast Cancer Screening Program.Material and Methods: Information about 1760 screen-detected ductal carcinoma in situ (DCIS) and 7366 invasive breast cancers diagnosed among women aged 50-69 years, 1996-2010, was analyzed. The screening mammograms were classified subjectively according to the amount of fibroglandular tissue into fatty, medium dense, and dense by breast radiologists. Chi-square test was used to compare the distribution of tumor characteristics by mammographic density. Odds ratio (OR) of tumor characteristics by density was estimated by means of logistic regression, adjusting for screening mode (screen-film and full-field digital mammography), and age.Results: Mean and median tumor size of invasive breast cancers was 13.8 and 12 mm, respectively, for women with fatty breasts, and 16.2 and 14mm for those with dense breasts. Lymph node positive tumors were identified among 20.6% of women with fatty breasts compared with 27.2% of those with dense breasts (P < 0.001). The proportion of DCIS was significantly lower for women with fatty (15.8%) compared with dense breasts (22.0%). Women with dense breasts had an increased risk of large (OR, 1.44; 95% CI, 1.18-1.73) and lymph node positive tumors (OR, 1.26; 95% CI, 1.05-1.51) compared with women with fatty and medium dense breasts.Conclusion: High mammographic density was positively associated with tumor size and lymph node positive tumors.