Hovhannisyan Gayane, Chow Lorraine, Schlosser Alexandra, Yaffe Martin J, Boyd Norman F, Martin Lisa J
Ontario Cancer Institute/University Health Network, Toronto, Ontario, Canada.
Cancer Epidemiol Biomarkers Prev. 2009 Jul;18(7):1993-9. doi: 10.1158/1055-9965.EPI-09-0074. Epub 2009 Jun 30.
In premenopausal women, the sensitivity of screening mammography for detecting breast cancer has been reported to be greater in the follicular phase than in the luteal phase of the menstrual cycle, which may be due to differences in mammographic density. To examine this possible effect, we compared mammographic density in premenopausal women who had mammograms at different phases of the menstrual cycle.
We recruited premenopausal women ages 40 to 49 years from two mammography units in Toronto, recorded the first day of the last menstrual period (LMP) and measured mammographic density using Cumulus software. We classified the time of the mammography examination as having occurred in one of four intervals, 1 (first week after LMP), 2 (second week after LMP), 3 (third week after LMP) and 4 (>3 weeks after LMP), and compared mammographic density across intervals.
Of the 936 women included in the analysis, 620 were examined by film and 316 by digital mammography. There were small and statistically nonsignificant variations in breast dense, nondense area, and percent density over the menstrual cycle in women examined by film mammography. Marginally significant variation in percent density was observed in the digital subset due to significant differences in the amount of nondense tissue over the menstrual cycle.
Variations in mammographic density over the menstrual cycle were small and nonsignificant for women examined by either film or digital mammography. Thus, timing of mammography in menstrual cycle is unlikely to have a significant influence in breast cancer detection by screening mammography.
据报道,在绝经前女性中,乳腺钼靶筛查检测乳腺癌的敏感性在月经周期的卵泡期高于黄体期,这可能是由于乳腺钼靶密度的差异所致。为了研究这种可能的影响,我们比较了在月经周期不同阶段进行乳腺钼靶检查的绝经前女性的乳腺钼靶密度。
我们从多伦多的两个乳腺钼靶检查单位招募了40至49岁的绝经前女性,记录末次月经第一天(LMP),并使用积云软件测量乳腺钼靶密度。我们将乳腺钼靶检查时间分为四个时间段之一,1(LMP后第一周)、2(LMP后第二周)、3(LMP后第三周)和4(LMP后>3周),并比较各时间段的乳腺钼靶密度。
纳入分析的936名女性中,620名接受了胶片乳腺钼靶检查,316名接受了数字乳腺钼靶检查。胶片乳腺钼靶检查的女性在月经周期中乳腺致密、非致密区域及密度百分比的变化较小,且无统计学意义。在数字乳腺钼靶检查的子集中,由于月经周期中非致密组织量的显著差异,观察到密度百分比有轻微的显著变化。
对于接受胶片或数字乳腺钼靶检查的女性,月经周期中乳腺钼靶密度的变化较小且无统计学意义。因此,月经周期中乳腺钼靶检查的时间不太可能对乳腺钼靶筛查检测乳腺癌产生显著影响。