Baseline Mammographic Breast Density and the Risk of Invasive Breast Cancer in Postmenopausal Women Participating in the NSABP Study of Tamoxifen and Raloxifene (STAR)
Baseline Mammographic Breast Density and the Risk of Invasive Breast Cancer in Postmenopausal Women Participating in the NSABP Study of Tamoxifen and Raloxifene (STAR)
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DOI：
10.1158/1940-6207.capr-12-0273
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发表时间：
2012-11-01
影响因子：
3.3
通讯作者：
Wolmark, Norman
中科院分区：
文献类型：
--
作者：
Cecchini, Reena S.;Costantino, Joseph P.;Wolmark, Norman
乳腺密度是乳腺癌的一个既定的危险因素。然而，结果是不确定的，其在风险预测模型中的使用。目前的研究评估了13,409名绝经后参与NSABP他莫昔芬和雷洛昔芬研究的受试者。根据美国放射学会乳腺成像报告和数据系统（BI-RADS）分类，提取并分类了录入乳房X线照片报告中报告的乳腺密度测量值。浸润性乳腺癌的风险增加与较高的乳腺钼靶摄影乳腺密度相关（P < 0.001）。在调整年龄、治疗和吸烟史后，以及添加到包括Gail评分的模型中时，这种相关性仍然显著[HR 1.35，95%置信区间（CI）：1.16-1.58]（HR 1.33，95% CI：1.14-1.55）。在随机分配后五年，时间依赖性曲线下面积（AUC）从仅使用Gail评分的模型的0.63改善到考虑乳腺密度和Gail评分时的0.64。乳腺密度也显着时，添加到一个简化的模型为雌激素受体阳性乳腺癌（P = 0.02）。在这项研究中，当与Gail评分结合考虑时，高BI-RADS乳腺密度与乳腺癌风险增加显著相关，但仅对预测浸润性乳腺癌发病率的Gail评分略有改善。BI-RADS乳腺成分分类系统是一种快速且易于获得的方法，用于评估乳腺密度以进行风险预测评价;然而，将其添加到Gail模型中似乎并未在乳腺癌风险增加的绝经后健康女性人群中提供实质性的可预测性改善。Cancer Prev Res; 5（11）; 1321-9. (C)2012年AACR。
Mammographic breast density is an established risk factor for breast cancer. However, results are inconclusive regarding its use in risk prediction models. The current study evaluated 13,409 postmenopausal participants in the NSABP Study of Tamoxifen and Raloxifene. A measure of breast density as reported on the entry mammogram report was extracted and categorized according to The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) classifications. An increased risk of invasive breast cancer was associated with higher mammographic breast density (P < 0.001). The association remained significant after adjusting for age, treatment, and smoking history [HR 1.35, 95% confidence interval (CI): 1.16-1.58], as well as when added to a model including the Gail score (HR 1.33,95% CI: 1.14-1.55). At five years after random assignment, time-dependent area under the curve (AUC) improved from 0.63 for a model with Gail score alone to 0.64 when considering breast density and Gail score. Breast density was also significant when added to an abbreviated model tailored for estrogen receptor-positive breast cancers (P = 0.02). In this study, high BI-RADS breast density was significantly associated with increased breast cancer risk when considered in conjunction with Gail score but provided only slight improvement to the Gail score for predicting the incidence of invasive breast cancer. The BI-RADS breast composition classification system is a quick and readily available method for assessing breast density for risk prediction evaluations; however, its addition to the Gail model does not seem to provide substantial predictability improvements in this population of postmenopausal healthy women at increased risk for breast cancer. Cancer Prev Res; 5(11); 1321-9. (C) 2012 AACR.