Mitchell Gillian, Antoniou Antonis C, Warren Ruth, Peock Susan, Brown Judith, Davies Russell, Mattison Jenny, Cook Margaret, Warsi Iqbal, Evans D Gareth, Eccles Diana, Douglas Fiona, Paterson Joan, Hodgson Shirley, Izatt Louise, Cole Trevor, Burgess Lucy, Eeles Ros, Easton Douglas F
Translational Cancer Genetics Team, Institute of Cancer Research and Cancer Genetics Unit, Royal Marsden NHS Hospital, United Kingdom.
Cancer Res. 2006 Feb 1;66(3):1866-72. doi: 10.1158/0008-5472.CAN-05-3368.
High breast density as measured on mammograms is a strong risk factor for breast cancer in the general population, but its effect in carriers of germline BRCA1 and BRCA2 mutations is unclear. We obtained mammograms from 206 female carriers of BRCA1 or BRCA2 mutations, 96 of whom were subsequently diagnosed with breast cancer and 136 relatives of carriers who were themselves noncarriers. We compared the mammographic densities of affected carriers (cases) and unaffected carriers (controls), and of mutation carriers and noncarriers, using a computer-assisted method of measurement and visual assessment by two observers. Analyses were adjusted for age, parity, body mass index, menopausal status, and hormone replacement therapy use. There was no difference in the mean percent density between noncarriers and carriers. Among carriers, increasing mammographic density was associated with an increased risk of breast cancer (P(trend) = 0.024). The odds ratio (OR; 95% confidence interval) for breast cancer associated with a density of > or =50% was 2.29 (1.23-4.26; P = 0.009). The OR did not differ between BRCA1 and BRCA2 carriers or between premenopausal and postmenopausal carriers. The results suggest that the distribution of breast density in BRCA1 and BRCA2 carriers is similar to that in non-carriers. High breast density in carriers is associated with an increased risk of breast cancer, with the relative risk being similar to that observed in the general population. Use of mammographic density could improve individual risk prediction in carriers.
乳房X光片上测量的高乳腺密度是一般人群患乳腺癌的一个重要风险因素，但其在携带种系BRCA1和BRCA2突变的人群中的作用尚不清楚。我们获取了206名携带BRCA1或BRCA2突变的女性的乳房X光片，其中96人随后被诊断患有乳腺癌，还有136名携带突变者的亲属，他们自己不携带突变。我们使用计算机辅助测量方法并由两名观察者进行视觉评估，比较了受影响的携带者（病例）和未受影响的携带者（对照）以及突变携带者和非携带者的乳房X光密度。分析对年龄、生育状况、体重指数、绝经状态和激素替代疗法的使用进行了调整。非携带者和携带者之间的平均密度百分比没有差异。在携带者中，乳房X光密度增加与患乳腺癌的风险增加相关（P趋势=0.024）。密度≥50%与乳腺癌相关的优势比（OR；95%置信区间）为2.29（1.23 - 4.26；P = 0.009）。BRCA1和BRCA2携带者之间或绝经前和绝经后携带者之间的OR没有差异。结果表明，BRCA1和BRCA2携带者的乳腺密度分布与非携带者相似。携带者中的高乳腺密度与患乳腺癌的风险增加相关，相对风险与在一般人群中观察到的相似。使用乳房X光密度可以改善携带者个体的风险预测。
