Breast Carcinoma In-Situ: Mammographic Risk Factors

描述(申请人提供)：随着使用乳房X光检查筛查妇女的努力增加，被诊断为乳腺癌原位癌(BCIS)的妇女人数也增加了。澄清乳房X光检查特征，如乳房X光检查乳房密度(MBD)与BCIS风险的作用非常重要，因为1)多达20%的筛查乳腺癌患者被诊断为这种病变，以及2)MBD增加与浸润性乳腺癌风险增加2-6倍相关。该项目将通过收集和回顾迄今为止最大的基于人群的BCIS病例/对照研究中的乳房X光照片，首次研究这种相关性。样本包括康涅狄格州9/15/94-3/14/98年9/15-3/14期间确诊的所有20岁至79岁的女性BCIS病例以及一系列年龄匹配的随机数字拨号对照；这些妇女(875例导管原位癌、123例小叶原位癌和999例对照)被作为我们BCIS结果研究的一部分进行跟踪调查。已经收集的信息包括1)关于癌症家族史、怀孕月经史、外源性激素使用以及癌症筛查史的问卷数据，2)关于生活方式和医疗结果的随访访谈数据，3)用于ER、PR、P53和HER-2/neu受体免疫组织化学检测的石蜡包埋肿瘤块，以及4)用于检测BRCA1/BRCA2突变的血液样本。我们将检查1)MBD增加或改变是否与BCIS风险相关，以及2)临床变量、乳房X光检查特征和预后之间是否存在相关性。这些信息将被用来3)改进我们的乳腺癌风险模型，并4)检查乳房X光检查是否可以根据高风险和低风险结果来表征。将乳房X光检查添加到先前存在的流行病学队列中，以其独特的学科组成、高参与率、集中的病理审查和多学科数据收集而闻名，这是一个具有成本效益和科学价值的机会。

DESCRIPTION (provided by applicant): As efforts to screen women using mammography have increased, so has the number of women diagnosed with breast carcinoma in-situ (BCIS). Clarification of the role of mammographic characteristics, such as mammographic breast density (MBD), with BCIS risk is important as 1) Up to 20% of screened breast cancer patients are diagnosed with this lesion and 2) increased MBD is associated with a 2-6 fold increase in the risk of invasive breast cancer. This project will study this association for the first time by collecting and reviewing mammograms in the largest population-based, case/control study of BCIS to date. The sample includes all cases of female BCIS aged 20 to 79 years diagnosed among residents of Connecticut from 9/15/94-3/14/98 as well as a series of age-matched random-digit-dial controls; these women (875 ductal carcinoma in-situ cases, 123 Iobular in-situ cases and 999 controls) are followed as part of our BCIS outcomes study. Information already collected includes 1) questionnaire data on family history of cancer, pregnancy menstrual history, exogenous hormone use, as well as cancer screening history, 2) follow-up interview data on lifestyle and medical outcomes, and, for cases, 3) paraffin embedded tumor blocks for immunohistochemical testing of ER, PR, p53 and HER-2/neu receptors, as well as 4) blood-samples for testing of mutations in BRCA1/BRCA2. We will examine whether 1) increased MBD or change in MBD is associated with BCIS risk, and 2) whether any correlation exists between clinical variables, mammographic characteristics, and outcome. This information will be used to 3) refine our models of breast cancer risk and to 4) examine whether mammograms can be characterized with respect to high and low risk outcomes. The addition of mammograms to a pre-existing epidemiologic cohort notable for its unique subject compositition, high participation rates, centralized pathology review and multi-disciplinary data collection, is a cost-efficient and scientifically valuable opportunity.