Volume of mammographic density and risk of breast cancer.
Volume of mammographic density and risk of breast cancer.
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DOI：
10.1158/1055-9965.epi-10-1150
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发表时间：
2011-07
期刊：
影响因子：
--
通讯作者：
Cummings SR
中科院分区：
文献类型：
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作者：
Shepherd JA;Kerlikowske K;Ma L;Duewer F;Fan B;Wang J;Malkov S;Vittinghoff E;Cummings SR
与基于定性评分或致密乳腺面积的方法相比，评估乳腺摄影密度的体积可能更准确地反映存在恶变风险的乳腺体积的量，并提供更强的乳腺癌风险指示。我们前瞻性地收集了接受筛查性乳腺X线摄影的女性的乳腺X线照片。我们确定了275例浸润性或导管原位癌（DCIS）的诊断，选择了825例年龄、种族和乳腺X线摄影系统相匹配的对照，并评估了乳腺密度的三个指标：致密面积百分比、纤维腺体体积和纤维腺体体积百分比。在调整家族性乳腺癌史、体重指数、乳腺活检史和首次活产年龄后，最高与最低测量值五分位数中乳腺癌风险的比值比为2.5（95% CI：1.5，4.3），纤维腺体体积为2.9（95% CI：1.7，4.9），纤维腺体体积为4.1（95% CI：2.3，7.2）。密度测量加上风险因素与单独风险因素的净重新分类指数分别为9.6%（P=0.07）的致密面积百分比，21.1%（P=0.0001）的纤维腺体体积和14.8%（P=0.004）的纤维腺体体积百分比。纤维腺体体积改善了乳腺癌和非乳腺癌妇女中1/5的分类风险分类。乳腺密度的体积测量比单独的风险因素和密度面积百分比更准确地预测乳腺癌风险。包括致密纤维腺体体积的风险模型可能比当前的风险模型更准确地预测乳腺癌风险。
Assessing the volume of mammographic density might more accurately reflect the amount of breast volume at risk of malignant transformation and provide a stronger indication of risk of breast cancer than methods based on qualitative scores or dense breast area. We prospectively collected mammograms for women undergoing screening mammography. We determined the diagnosis of subsequent invasive or ductal carcinoma in situ (DCIS) for 275 cases, selected 825 controls matched for age, ethnicity, and mammography system, and assessed three measures of breast density: percent dense area, fibroglandular volume, and percent fibroglandular volume. After adjustment for familial breast cancer history, body mass index, history of breast biopsy, and age at first live birth, the odds ratios for breast cancer risk in the highest versus lowest measurement quintiles were 2.5 (95% CI: 1.5, 4.3) for percent dense area, 2.9 (95% CI: 1.7, 4.9) for fibroglandular volume, and 4.1 (95% CI: 2.3, 7.2) for percent fibroglandular volume. Net reclassification indexes for density measures plus risk factors versus risk factors alone were 9.6% (P=0.07) for percent dense area, 21.1% (P=0.0001) for fibroglandular volume, and 14.8% (P=0.004) for percent fibroglandular volume. Fibroglandular volume improved the categorical risk classification of 1 in 5 women for both women with and without breast cancer. Volumetric measures of breast density are more accurate predictors of breast cancer risk than risk factors alone and than percent dense area. Risk models including dense fibroglandular volume may more accurately predict breast cancer risk than current risk models.