Automated volumetric breast density measures: differential change between breasts in women with and without breast cancer
Automated volumetric breast density measures: differential change between breasts in women with and without breast cancer
复制标题
DOI：
10.1186/s13058-019-1198-9
复制
发表时间：
2019-10-28
影响因子：
7.4
通讯作者：
Vachon, Celine M.
中科院分区：
文献类型：
--
作者：
Brandt, Kathleen R.;Scott, Christopher G.;Vachon, Celine M.
背景：考虑到乳腺癌和正常致密纤维腺组织具有相似的放射学衰减，我们研究了自动体积密度测量是否能识别癌症女性乳房之间的差异变化，并与健康对照进行比较。方法：符合条件的单侧浸润性乳腺癌患者（n = 1160）在诊断前2个月和1-5年两个时间点进行双侧全视野数字乳房x光检查（ffdm）。对照（n = 2360）与年龄和ffdm日期相匹配。使用Volpara （TM）评估每个乳房的致密体积（DV）和体积百分比密度（VPD）。分别计算病例和对照组乳房x光片间DV和VPD的差异（间隔中位数为3年），并使用Wilcoxon符号秩检验评估其差异。为了模拟临床实践中癌症侧边未知的情况，我们使用ROC曲线下面积（AUC）分析，调整年龄、BMI和时间，检查乳房之间的绝对差异是否可以区分病例和对照组。结果：与正常乳腺（-0.39%和-2.74 cm(3)）相比，癌性乳腺乳腺x线片间VPD和DV下降程度较低（-0.26%和-2.10 cm(3)），差异分别为0.13% （p值< 0.001）和0.63 cm(3) （p = 0.002）。在对照组中，乳房之间VPD （-0.02 [p = 0.92]）和DV （0.05 [p = 0.77]）的差异几乎相同。使用乳房之间的绝对差异区分病例与对照组的AUC为VPD为0.54 (95% CI 0.52, 0.56)， DV为0.56 （95% CI 0.54, 0.58）。结论：随着时间的推移，乳腺癌患者的体积密度测量值有较小的相对增加，这在正常乳腺中是没有的。然而，这种差异的幅度很小，而且这一指标本身似乎并不能很好地区分患有乳腺癌和没有乳腺癌的女性。
Background: Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify a differential change between breasts in women with cancer and compare to healthy controls.Methods: Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms (FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to cases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were assessed using Volpara (TM). Differences in DV and VPD between mammograms (median 3 years apart) were calculated per breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test. To simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference between breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for age, BMI, and time.Results: Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser degree (-0.26% and -2.10 cm(3)) than the normal breast (-0.39% and -2.74 cm(3)) for a difference of 0.13% (p value < 0.001) and 0.63 cm(3) (p = 0.002), respectively. Among controls, the differences between breasts were nearly identical for VPD (-0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using absolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV.Conclusion: There is a small relative increase in volumetric density measures over time in the breast with cancer which is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone does not appear to be a good discriminator between women with and without breast cancer.