Effects of age, breast density, ethnicity, and estrogen replacement therapy on screening mammographic sensitivity and cancer stage at diagnosis: Review of 183,134 screening mammograms in Albuquerque, New Mexico
Effects of age, breast density, ethnicity, and estrogen replacement therapy on screening mammographic sensitivity and cancer stage at diagnosis: Review of 183,134 screening mammograms in Albuquerque, New Mexico
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DOI：
10.1148/radiology.209.2.9807581
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发表时间：
1998-11-01
期刊：
影响因子：
19.7
通讯作者：
Linver, MN
中科院分区：
文献类型：
--
作者：
Rosenberg, RD;Hunt, WC;Linver, MN
目的：探讨常见的患者因素如何影响筛查乳房x线摄影敏感性和诊断时的癌症分期。材料和方法：作者使用了一个基于人群的数据库，包括183,134张筛查性乳房x线照片和一个全州范围的肿瘤登记处，以确定筛查性乳房x线照片中检测到的807例乳腺癌。结果：敏感性随种族、雌激素替代疗法的使用、乳房x光片乳腺密度和年龄的不同而有显著差异。40岁以下女性的敏感性为54%(13 / 24)，40-49岁女性的敏感性为77%(157 / 157)，50-64岁女性的敏感性为78%(224 / 286)，64岁以上女性的敏感性为81%（277 / 340）。对致密乳房的敏感性为68%（237人中的162人），对非致密乳房的敏感性为85%（356人中的302人），对雌激素替代疗法使用者的敏感性为74%（244人中的180人），对未使用雌激素替代疗法者的敏感性为81%（513人中的417人）。致密乳房联合雌激素替代疗法的敏感性降低最为明显；当只有一个因素存在时，差异不大。中位肿瘤大小和早期癌症的百分比与任何因素都没有什么变化。结论：年龄是40岁以上女性乳房x线摄影敏感性的次要决定因素。在高乳腺密度和雌激素替代疗法的联合使用下，敏感性大大降低。在乳房x光检查敏感度较低的组中，癌症结果没有显著变化。这些数据不支持40-49岁女性或雌激素替代疗法使用者的不同筛查建议。
Purpose: To examine how common patient factors affect screening mammographic sensitivity and cancer stage at diagnosis.Materials and methods: The authors used a population-based database of 183,134 screening mammograms and a statewide tumor registry to identify 807 breast cancers detected at screening mammography.Results: Sensitivity varied significantly with ethnicity, use of estrogen replacement therapy, mammographic breast density and age. Sensitivity was 54% (13 of 24) in women younger than 40 years, 77% (121 of 157) in women aged 40-49 years, 78% (224 of 286) in women aged 50-64 years, and 81% (277 of 340) in women older than 64 years. Sensitivity was 68% (162 of 237) for dense breasts and 85% (302 of 356) for nondense breasts and 74% (180 of 244) in estrogen replacement therapy users and 81 % (417 of 513) in non users. Sensitivity was most markedly reduced with the combination of dense breasts and estrogen replacement therapy use; there was little difference when only one factor was present. Median cancer size and the percentage of early cancers showed little change with any factors.Conclusion: Age is a minor determinant of mammographic sensitivity in women aged 40 years or older. Sensitivity is substantially decreased with the combination of higher breast density and estrogen replacement therapy use. There was not a notable shift in cancer outcomes in the groups with lower mammographic sensitivity. These data do not support different screening recommendations in women aged 40-49 years or in estrogen replacement therapy users.