Warner E, Lockwood G, Tritchler D, Boyd N F
Division of Epidemiology and Statistics, Ontario Cancer Institute, Toronto, Canada.
Cancer Detect Prev. 1992;16(1):67-72.
The appearance of the breast parenchyma as seen on mammography is known to vary between individuals. The evidence is reviewed that some of the sources of this variation, namely, the densities referred to as "dysplasia", are related to breast cancer risk. We have carried out a meta-analysis of the published literature to determine the magnitude of the risk of breast cancer associated with mammographic densities by calculating summary odds ratios for studies grouped according to their design and the method used to classify mammographic parenchymal patterns. This has shown that subjects with mammographic densities have an increased risk of breast cancer relative to those without densities. Of the studies that used Wolfe's method of classification, cohort studies (n = 8) had a summary odds ratio of 5.19 (95% CI, 3.6 to 7.48); case control studies (n = 13) had a summary odds ratio of 1.8 (95% CI, 1.5 to 2.13); and prevalence surveys had a summary odds ratio of 0.54 (95% CI, 0.4 to 0.7). Other methods of classification, using quantitative estimates of the proportion of the breast occupied by densities, gave substantially higher odds ratios than Wolfe's system. The ability to recognize individuals within the population at different risks for breast cancer could be exploited in studies of potential etiological factors.
乳腺钼靶检查中所见的乳腺实质外观在个体之间存在差异，这是已知的。有证据表明，这种差异的一些来源，即被称为“发育异常”的密度，与乳腺癌风险相关。我们对已发表的文献进行了荟萃分析，通过计算根据研究设计和用于分类乳腺钼靶实质模式的方法分组的研究的汇总比值比，来确定与乳腺钼靶密度相关的乳腺癌风险程度。结果表明，与没有密度的受试者相比，有乳腺钼靶密度的受试者患乳腺癌的风险增加。在使用沃尔夫分类法的研究中，队列研究（n = 8）的汇总比值比为5.19（95%可信区间，3.6至7.48）；病例对照研究（n = 13）的汇总比值比为1.8（95%可信区间，1.5至2.13）；患病率调查的汇总比值比为0.54（95%可信区间，0.4至0.7）。使用密度占乳腺比例的定量估计的其他分类方法给出的比值比明显高于沃尔夫系统。在潜在病因因素的研究中，可以利用识别乳腺癌不同风险人群中个体的能力。
