del Carmen Marcela G, Hughes Kevin S, Halpern Elkan, Rafferty Elizabeth, Kopans Daniel, Parisky Yuri R, Sardi Armando, Esserman Lisa, Rust Steven, Michaelson James
Vincent Memorial Gynecologic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Cancer. 2003 Aug 1;98(3):590-6. doi: 10.1002/cncr.11517.
African American women have a lower incidence but a higher mortality from breast carcinoma than Caucasians. A proposed explanation for this discrepancy is the decreased efficacy of screening among African American women. Increased breast density in African American women may result in decreased sensitivity of mammography. The purpose of this article is to determine whether there is a difference in mammographic breast density between African American and Caucasian women.
A series of 769 women were recruited from 5 sites. Mammograms were reviewed centrally by seven reviewers using Breast Imaging Reporting and Data System categories converted to numeric values. The mean mammographic densities for Caucasian, African American, and Latina patients were compared using a two-way analysis of covariance. The mean values for each race were estimated adjusting for the reader as well as for each patient's age and body mass index (BMI).
African American women had the lowest mean breast density. The reported density in this group was 2.43, compared with 2.69 among Caucasians and 2.65 among Latina patients. After adjusting for age and BMI as well as the reader, there was still an independent racial effect on breast density (P = 0.0050).
Mammographic breast density was lower in African American women than in Caucasians and Latinas. This discrepancy may be an intrinsic racial difference due to undetermined causes. Factors, such as the growth rate of tumors and the incidence of calcifications, must be studied to confirm that other forces do not have a negative impact on the efficacy of screening mammograms in African American women.
非裔美国女性乳腺癌的发病率低于白种人，但死亡率却高于白种人。对于这种差异，一种可能的解释是，非裔美国女性筛查的效果较差。非裔美国女性乳房密度增加可能导致乳房X线摄影的敏感性降低。本文旨在确定非裔美国女性和白种女性在乳房X线摄影密度上是否存在差异。
从5个地点招募了769名女性。由7名阅片者集中对乳房X线照片进行评估，使用乳房影像报告和数据系统分类并转换为数值。采用双向协方差分析比较白种人、非裔美国人和拉丁裔患者的平均乳房X线摄影密度。根据阅片者以及每位患者的年龄和体重指数（BMI）对每个种族的平均值进行估计。
非裔美国女性的平均乳房密度最低。该组报告的密度为2.43，而白种人为2.69，拉丁裔患者为2.65。在对年龄、BMI以及阅片者进行校正后，乳房密度仍存在独立的种族效应（P = 0.0050）。
非裔美国女性的乳房X线摄影密度低于白种人和拉丁裔。这种差异可能是由未确定原因导致的内在种族差异。必须研究肿瘤生长速度和钙化发生率等因素，以确认其他因素不会对非裔美国女性乳房X线筛查的效果产生负面影响。
