Palomares Melanie R, Machia Joelle R B, Lehman Constance D, Daling Janet R, McTiernan Anne
City of Hope National Medical Center, Duarte, CA 91010, USA.
Cancer Epidemiol Biomarkers Prev. 2006 Jul;15(7):1324-30. doi: 10.1158/1055-9965.EPI-05-0689.
The Gail model is a validated breast cancer risk assessment tool that is primarily based on nonmodifiable breast cancer risk factors. Conversely, mammographic breast density is strongly correlated with breast cancer risk and responds to risk-modifying interventions. The purpose of our study was to correlate mammographic density with breast cancer risk as calculated by the Gail model and to examine the relative association of each of the model covariates to mammographic density.
The study included 99 participants of the National Surgical Breast and Bowel Project P-1 trial, ages 36 to 74 years, all of whom had a mammogram and Gail model risk estimates done upon trial entry. Baseline mammograms were retrieved and digitized, and mammographic density was assessed by both subjective and computer-assisted objective measures.
Mammographic density was 2-fold higher in women with a >15% lifetime risk of breast cancer compared with those with <15% risk, by all density assessment methods. This was equivalent to a 3% to 6% increase in density per 10% increase in risk. Gail model covariates that measured benign or premalignant breast tissue changes accounted for the majority (41%) of the relationship with increased mammographic density. Seven percent of density was not explained by risk factors included in the Gail model.
The Gail model does not fully account for the association between breast density and calculated breast cancer risk. Because mammographic density is a modifiable marker, development of a breast cancer risk assessment tool that includes mammographic density could be beneficial for assessing individual risk.
盖尔模型是一种经过验证的乳腺癌风险评估工具，主要基于不可改变的乳腺癌风险因素。相反，乳腺钼靶摄影的乳房密度与乳腺癌风险密切相关，并且对风险修正干预有反应。我们研究的目的是将乳腺钼靶密度与盖尔模型计算出的乳腺癌风险相关联，并检验该模型各协变量与乳腺钼靶密度的相对关联。
该研究纳入了国家外科乳腺和肠道项目P-1试验的99名参与者，年龄在36至74岁之间，所有参与者在试验入组时均进行了乳房X光检查和盖尔模型风险评估。检索并数字化基线乳房X光片，通过主观和计算机辅助客观测量方法评估乳腺钼靶密度。
通过所有密度评估方法，终生患乳腺癌风险>15%的女性的乳腺钼靶密度是风险<15%的女性的2倍。这相当于风险每增加10%，密度增加3%至6%。盖尔模型中测量良性或癌前乳腺组织变化的协变量占乳腺钼靶密度增加相关性的大部分（41%）。盖尔模型中包含的风险因素无法解释7%的密度变化。
盖尔模型没有完全解释乳腺密度与计算出的乳腺癌风险之间的关联。由于乳腺钼靶密度是一个可改变的指标，开发一种包含乳腺钼靶密度的乳腺癌风险评估工具可能有助于评估个体风险。
