Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynaecology and Pediatrics, Dalhousie University, Nova Scotia, Canada.
Int J Cancer. 2011 Jul 15;129(2):440-8. doi: 10.1002/ijc.25676. Epub 2010 Nov 16.
Whereas mammographic density and adiposity are positively associated with postmenopausal breast cancer risk, they are inversely associated with one another. To examine the association between these two risk factors, a secondary analysis of data from a randomized controlled trial of a year-long aerobic exercise intervention was done. Participants were 302 postmenopausal women aged 50-74 years. Dense fibroglandular and nondense fatty tissue were measured from mammograms using computer-assisted thresholding software for area measurements and a technique relying on the calibration of mammography machines with a tissue-equivalent phantom for volumetric measurements. Adiposity was measured by anthropometry (body mass index, waist circumference), whole-body dual x-ray absorptiometry scans (body fat) and computed tomography scans (abdominal adiposity). Correlations were estimated between and within women, the latter representing the association between the 1-year change in adiposity and mammographic measures. Adiposity was correlated with nondense area and volume (0.50 ≤ r ≤ 0.66 between women; 0.18 ≤ r ≤ 0.46 within women). Between women, adiposity was correlated with dense area and volume (-0.12 ≤ r ≤ -0.30) and with percent dense area and volume (-0.28 ≤ r ≤ -0.48). Because measurements made with scans explained at most only 3% more of the variation in absolute or percent density beyond that explained by anthropometric measurements, anthropometric measurements are likely sufficient for adjustment of the association between mammographic density and breast cancer risk. Adiposity is associated with breast fatty tissue and possibly weakly inversely associated with fibroglandular tissue.
虽然乳腺密度和肥胖与绝经后乳腺癌风险呈正相关,但它们之间呈负相关。为了研究这两个危险因素之间的关系,对一项为期一年有氧运动干预的随机对照试验的数据进行了二次分析。参与者是 302 名年龄在 50-74 岁之间的绝经后妇女。使用计算机辅助阈值软件对乳腺 X 光片进行致密纤维腺体和非致密脂肪组织的面积测量,并采用依赖于乳腺 X 光机校准的技术,使用组织等效体模进行体积测量。通过人体测量(体重指数、腰围)、全身双能 X 射线吸收仪扫描(体脂)和计算机断层扫描(腹部肥胖)来测量肥胖程度。在女性之间和女性内部估计了相关性,后者代表了肥胖程度的 1 年变化与乳腺 X 光测量之间的关联。肥胖程度与非致密面积和体积呈正相关(女性之间的相关性为 0.50≤r≤0.66;女性内部的相关性为 0.18≤r≤0.46)。在女性之间,肥胖程度与致密面积和体积呈负相关(-0.12≤r≤-0.30),与致密面积和体积的百分比呈负相关(-0.28≤r≤-0.48)。由于扫描测量最多只能解释除人体测量外,绝对或百分比密度变化的 3%,因此人体测量可能足以调整乳腺密度与乳腺癌风险之间的关联。肥胖与乳房脂肪组织有关,可能与纤维腺体组织呈弱负相关。