Aiello Erin J, Buist Diana S M, White Emily, Porter Peggy L
Group Health Cooperative, Center for Health Studies, Seattle, WA 98101, USA.
Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):662-8. doi: 10.1158/1055-9965.EPI-04-0327.
Few studies have examined the association between breast density and breast cancer tumor characteristics. We examined the association between hormonal, proliferative, and histologic tumor characteristics and mammographic breast density in women with breast cancer.
We conducted a cross-sectional analysis in 546 women diagnosed with invasive breast cancer to evaluate the associations between breast density and tumor size, lymph node status, lymphatic or vascular invasion, histologic grade, nuclear grade, tumor differentiation, mitotic index, tumor necrosis, Ki-67 proliferation, estrogen receptor, progesterone receptor, p53, p27, cyclin E, Bcl-2, and C-erb-B2 invasion. Breast density was classified as fatty (Breast Imaging Reporting and Data System code 1 or 2; n = 373) or dense (Breast Imaging Reporting and Data System code 3 or 4; n = 173) for the cancer-free breast. A single pathologist measured all tumor markers. We examined whether the relationships were modified by interval cancer or screen-detected cancer.
Women with a tumor size >1.0 cm were more likely to have dense breasts compared with women with a tumor size < or =1.0 cm after adjusting for confounders (odds ratio, 2.0; 95% confidence interval, 1.2-3.4 for tumor sizes 1.1-2.0 cm; odds ratio, 2.3; 95% confidence interval, 1.3-4.4 for tumor sizes 2.1-10 cm). Tumor size, lymph node status, and lymphatic or vascular invasion were positively associated with breast density among screen-detected cancers. Histologic grade and mitotic index were negatively associated with breast density in women diagnosed with an interval cancer.
These results suggest that breast density is related to tumor size, lymph node status, and lymphatic or vascular invasion in screen-detected cancers. Additional studies are needed to address whether these associations are due to density masking the detection of some tumors, a biological relationship, or both.
很少有研究探讨乳腺密度与乳腺癌肿瘤特征之间的关联。我们研究了激素、增殖和组织学肿瘤特征与乳腺癌女性乳房钼靶密度之间的关联。
我们对546例诊断为浸润性乳腺癌的女性进行了横断面分析，以评估乳腺密度与肿瘤大小、淋巴结状态、淋巴管或血管侵犯、组织学分级、核分级、肿瘤分化、有丝分裂指数、肿瘤坏死、Ki-67增殖、雌激素受体、孕激素受体、p53、p27、细胞周期蛋白E、Bcl-2和C-erb-B2侵犯之间的关联。将无癌乳房的乳腺密度分类为脂肪型（乳腺影像报告和数据系统代码1或2；n = 373）或致密型（乳腺影像报告和数据系统代码3或4；n = 173）。由一名病理学家测量所有肿瘤标志物。我们研究了这些关系是否因间期癌或筛查发现的癌症而有所改变。
在调整混杂因素后，肿瘤大小>1.0 cm的女性与肿瘤大小≤1.0 cm的女性相比，更有可能具有致密型乳房（对于肿瘤大小为1.1 - 2.0 cm的情况，比值比为2.0；95%置信区间为1.2 - 3.4；对于肿瘤大小为2.1 - 10 cm的情况，比值比为2.3；95%置信区间为1.3 - 4.4）。在筛查发现的癌症中，肿瘤大小、淋巴结状态以及淋巴管或血管侵犯与乳腺密度呈正相关。在诊断为间期癌的女性中，组织学分级和有丝分裂指数与乳腺密度呈负相关。
这些结果表明，在筛查发现的癌症中，乳腺密度与肿瘤大小、淋巴结状态以及淋巴管或血管侵犯有关。需要进一步研究来探讨这些关联是由于密度掩盖了某些肿瘤的检测、生物学关系，还是两者兼而有之。
