A longitudinal investigation of mammographic density: The multiethnic cohort
A longitudinal investigation of mammographic density: The multiethnic cohort
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DOI：
10.1158/1055-9965.epi-05-0798
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发表时间：
2006-04-01
影响因子：
3.8
通讯作者：
Kolonel, LN
中科院分区：
文献类型：
--
作者：
Maskarinec, G;Pagano, I;Kolonel, LN
假设乳房x线摄影密度反映了影响乳腺癌发病率的危险因素的累积暴露。该报告分析了随时间变化的密度百分比，并探讨了密度变化与年龄的关系。研究人群包括607例乳腺癌患者和667例频率匹配的对照组，分别有1956例和1619例乳房x光检查读数。在诊断出乳腺癌之前，在20年前进行的乳房x光检查使用计算机辅助方法评估了密度。使用多层次模型允许重复测量，我们估计了种族、病例状态、生殖特征、激素治疗、体重指数和大豆摄入量对初始状态和纵向变化的影响。将百分比密度曲线下的面积进行整合后，将累积百分比密度与夏威夷特定年龄的乳腺癌发病率进行比较。密度百分比每10年下降5.6%，但非线性效应表明在生命早期下降得更快。累积密度百分比和特定年龄的乳腺癌发病率以非常相似的速度增长；标准化回归系数均为0.9。日本血统，超重，雌激素/黄体酮治疗，以及在较小程度上，仅雌激素治疗，随着年龄的增长，密度下降速度较慢。病例状态和成人大豆摄入量与较高的密度有关，而超重和有孩子则与初始状态时较低的密度有关。随着时间的推移，影响乳房x线摄影密度下降的风险因素可能对预防乳腺癌很重要，因为累积的百分比密度可能反映出与年龄相关的乳腺癌风险增加。
Mammographic densities are hypothesized to reflect the cumulative exposure to risk factors that influence breast cancer incidence. This report analyzed percent densities over time and explored predictors of density change in relation to age. The study population consisted of 607 breast cancer cases and 667 frequency matched controls with 1,956 and 1,619 mammographic readings, respectively. Mammograms done over > 20 years and before a diagnosis of breast cancer were assessed for densities using a computer-assisted method. Using multilevel modeling to allow for repeated measurements, we estimated the effect of ethnicity, case status, reproductive characteristics, hormonal therapy, body mass index, and soy intake on initial status and longitudinal change. After integrating the area under the percent density curve, cumulative percent density was compared with age-specific breast cancer rates in Hawaii. Percent densities decreased - 5.6% per 10 years but a nonlinear effect indicated a faster decline earlier in life. Cumulative percent densities and age-specific breast cancer rates increased at very similar rates; both standardized regression coefficients were > 0.9. Japanese ancestry, overweight, estrogen/progestin treatment, and, to a lesser degree, estrogen-only therapy predicted a slower decline in densities with age. Case status and adult soy intake were related to higher densities whereas overweight and having any child were associated with lower densities at initial status. Risk factors that influence the decline in mammographic densities over time may be important for breast cancer prevention because cumulative percent densities may reflect the age-related increase in breast cancer risk.