Mammographic Density and Risk of Contralateral Breast Cancer

乳房X光密度和对侧乳腺癌的风险

• 批准号: 8547796
• 负责人: JONINE L. BERNSTEIN
• 金额: $ 54.66万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-19 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8547796
• 关键词: Address; Adipose tissue; Aftercare; Area; Breast; Breast Cancer Treatment; Cancer Control; Categories; Chemotherapy-Oncologic Procedure; Clinical; Clinical Management; Clinical Markers; Consent; Contralateral; Data; Diagnosis; Epidemiology; Estrogens; Film; General Population; Glare; Health Personnel; High Risk Woman; Hormonal; Interview; Link; Malignant Neoplasms; Mammographic Density; Mammography; Measurement; Measures; Medical Records; Menopause; Meta-Analysis; Methods; Modality; Monitor; Noninfiltrating Intraductal Carcinoma; Odds Ratio; Outcome; Population Study; Premenopause; Preventive; Progesterone; Questionnaires; Radiation; Recruitment Activity; Research Design; Research Personnel; Resources; Retrieval; Risk; Risk Factors; Risk Management; Risk Marker; Role; Series; Survivors; Tamoxifen; Telephone Interviews; Time; Tissues; Variant; Woman; Women' s Health; breast cancer diagnosis; breast density; cancer risk; cancer therapy; chemotherapy; cost; density; environment related cancer; epidemiology study; high risk; improved; malignant breast neoplasm; modifiable risk; novel; population based; programs; response; screening

DESCRIPTION (provided by applicant): Mammographic density (MD) is a well-established and strong risk factor for first primary breast cancer. Women with invasive cancer in one breast are at 2-5 times higher risk of developing a contralateral breast cancer (CBC) compared to the general population risk of a first primary breast cancer. We and other researchers have shown that the treatment a woman receives for her first primary can alter her risk of developing CBC. Studies show MD is altered in response to some hormonal and other treatments, increasing with menopausal estrogen and progesterone therapy, and decreasing with tamoxifen, an anti-hormonal treatment as well as chemotherapy. It is plausible that MD, both before and after treatment, may be useful clinical markers of risk of CBC in women with a first primary breast cancer. As a result of improved screening and treatment, there are increasing numbers of survivors of breast cancer. However, there are few known clinical determinants of subsequent CBC, limiting women and health care providers in the assessment and management of this risk. The ongoing Women's Environmental, Cancer, and Radiation Epidemiology (WECARE) II Study is a population-based study of 800 CBC cases and 800 unilateral breast cancer (UBC) controls currently being recruited and interviewed, along with having their breast cancer diagnosis and treatment medical records reviewed. We now propose to: retrieve mammograms taken at, or within a year prior to, the first breast cancer diagnosis and those at 12-18 months following diagnosis; digitize film mammograms; and quantitatively assess MD using both the well-established standard thresholding method (Cumulus) and a novel automated density measure (Variation or "V"). Our Primary Specific Aims are: 1. To estimate the relationship between MD (both %MD and absolute dense area, using the Cumulus thresholding program) of the contralateral breast around the time of the first diagnosis (at or up to one year prior) and the rik of a subsequent diagnosis of CBC invasive breast cancer in the contralateral breast; 2. To estimate the relationship between MD (both %MD and dense area, using Cumulus) of the contralateral breast at 12-18 months following initial diagnosis (when initial chemotherapy and radiation treatments are likely completed) and the risk of a subsequent diagnosis of invasive breast cancer in the contralateral breast; and 3. To assess changes in MD of the contralateral breast before and after treatment (and/or after initiation of hormonal treatment) by treatment modality. Our Secondary Specific Aims are: 1. To estimate whether change in MD (%MD or dense area) of the contralateral breast before and after treatment is associated with risk of a subsequent diagnosis of invasive breast cancer in the contralateral breast; 2.To address the above Aims using V, an automated, validated, breast density measurement and compare results with those derived from the Cumulus measure. The novel study we propose could be useful for identifying women at high risk of CBC and it addresses an understudied issue that is of high clinical importance to the many women who survive their first primary breast cancer.

描述（由申请人提供）：乳房X光密度（MD）是第一原发性乳腺癌的公认且强烈的危险因素。与一般人群患第一原发性乳腺癌的风险相比，单侧乳房患有浸润性癌症的女性患对侧乳腺癌 (CBC) 的风险要高 2-5 倍。我们和其他研究人员已经证明，女性第一次初选时接受的治疗可以改变她患 CBC 的风险。研究表明，MD 会因某些激素和其他治疗而改变，随着绝经期雌激素和黄体酮治疗而增加，而随着他莫昔芬（一种抗激素治疗以及化疗）的减少而减少。治疗前和治疗后的 MD 可能是首次原发性乳腺癌女性 CBC 风险的有用临床标志物。由于筛查和治疗的改进，乳腺癌幸存者数量不断增加。然而，随后 CBC 的已知临床决定因素很少，限制了妇女和医疗保健提供者评估和管理这种风险。 正在进行的女性环境、癌症和辐射流行病学 (WECARE) II 研究是一项基于人群的研究，目前正在招募和采访 800 例 CBC 病例和 800 例单侧乳腺癌 (UBC) 对照，并审查他们的乳腺癌诊断和治疗病历。我们现在建议：检索首次乳腺癌诊断时或之前一年内以及诊断后 12-18 个月时拍摄的乳房 X 光检查；数字化胶片乳房X光检查；并使用完善的标准阈值方法（积云）和新颖的自动密度测量（变化或“V”）定量评估 MD。我们的主要具体目标是： 1. 估计首次诊断时（一年前或一年前）对侧乳房的 MD（%MD 和绝对致密面积，使用积云阈值程序）与随后诊断对侧乳房 CBC 浸润性乳腺癌的风险之间的关系； 2. 评估初次诊断后 12-18 个月（当初始化疗和放疗可能完成时）对侧乳房的 MD（%MD 和致密面积，使用积云）与随后诊断对侧乳房浸润性乳腺癌的风险之间的关系； 3. 通过治疗方式评估治疗前后（和/或开始激素治疗后）对侧乳房 MD 的变化。我们的次要具体目标是： 1. 评估治疗前后对侧乳腺 MD（%MD 或致密区）的变化是否与随后诊断对侧乳腺浸润性乳腺癌的风险相关； 2. 为了实现上述目标，使用 V（一种自动化、经过验证的乳腺密度测量）并将结果与​​积云测量得出的结果进行比较。我们提出的这项新研究可能有助于识别 CBC 高风险女性，它解决了一个尚未得到充分研究的问题，该问题对于许多首次原发性乳腺癌存活下来的女性具有很高的临床重要性。