Ziv Elad, Shepherd John, Smith-Bindman Rebecca, Kerlikowske Karla
Division of General Internal Medicine and Department of Medicine, University of California, San Francisco, USA.
J Natl Cancer Inst. 2003 Apr 2;95(7):556-8. doi: 10.1093/jnci/95.7.556.
The association between mammographic breast density and breast cancer risk may be the result of genetic and/or environmental factors that determine breast density. We reasoned that if the genetic factors that underlie breast density increase breast cancer risk, then breast density should be associated with family history of breast cancer. Therefore, we determined the association between mammographic density and family history of breast cancer among women in the San Francisco Mammography Registry. Mammographic density was classified using the four BI-RADS criteria: 1 = almost entirely fatty, 2 = scattered fibroglandular tissue, 3 = heterogeneously dense, and 4 = extremely dense. We adjusted for age, body mass index, hormone replacement therapy use, menopause status, and personal history of breast cancer. Compared with women with BI-RADS 1 readings, women with higher breast density were more likely to have first-degree relatives with breast cancer (BI-RADS 2, odds ratio [OR] = 1.37, 95% confidence interval [CI] = 0.96 to 1.89; BI-RADS 3, OR = 1.70, 95% CI = 1.19 to 2.40; BI-RADS 4, OR = 1.70, 95% CI = 1.05 to 2.71). Thus, the genetic factors that determine breast density may determine breast cancer risk.
乳腺钼靶密度与乳腺癌风险之间的关联可能是由决定乳腺密度的遗传和/或环境因素导致的。我们推断，如果构成乳腺密度基础的遗传因素会增加乳腺癌风险，那么乳腺密度应该与乳腺癌家族史相关。因此，我们在旧金山乳腺钼靶登记处的女性中确定了乳腺钼靶密度与乳腺癌家族史之间的关联。乳腺钼靶密度使用四种BI-RADS标准进行分类：1 = 几乎全为脂肪型，2 = 散在纤维腺体组织，3 = 不均匀致密，4 = 极度致密。我们对年龄、体重指数、激素替代疗法使用情况、绝经状态和乳腺癌个人史进行了校正。与BI-RADS 1级结果的女性相比，乳腺密度较高的女性更有可能有患乳腺癌的一级亲属（BI-RADS 2级，比值比[OR]=1.37，95%置信区间[CI]=0.96至1.89；BI-RADS 3级，OR = 1.70，95% CI = 1.19至2.40；BI-RADS 4级，OR = 1.70，95% CI = 1.05至2.71）。因此，决定乳腺密度的遗传因素可能决定乳腺癌风险。
