Dai Hongji, Yan Ye, Wang Peishan, Liu Peifang, Cao Yali, Xiong Li, Luo Yahong, Pan Tie, Ma Xiangjun, Wang Jie, Yang Zhenhua, Liu Xueou, Chen Chuan, Huang Yubei, Li Yi, Wang Yaogang, Hao Xishan, Ye Zhaoxiang, Chen Kexin
Department of Epidemiology and Biostatistics and Department of Breast Imaging, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China, Prevention and Cure Center of Breast Disease, Third Hospital of Nanchang, Nanchang, China, Department of Medical Image and Department of Cancer Prevention and Control, Liaoning Cancer Institute and Hospital, Shenyang, China, Center for Breast Disease, Haidian Maternal and Child Health Hospital, Beijing, China, Department of Radiology, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China, Department of Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China and Chinese Anti-Cancer Association, Tianjin, China
Department of Epidemiology and Biostatistics and Department of Breast Imaging, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China, Prevention and Cure Center of Breast Disease, Third Hospital of Nanchang, Nanchang, China, Department of Medical Image and Department of Cancer Prevention and Control, Liaoning Cancer Institute and Hospital, Shenyang, China, Center for Breast Disease, Haidian Maternal and Child Health Hospital, Beijing, China, Department of Radiology, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China, Department of Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China and Chinese Anti-Cancer Association, Tianjin, China.
Int J Epidemiol. 2014 Aug;43(4):1240-51. doi: 10.1093/ije/dyu042. Epub 2014 Mar 16.
Mammographic density (MD) has not been systematically investigated among Chinese women. Breast cancer screening programmes provided detailed information on MD in a large number of asymptomatic women.
In the Multi-modality Independent Screening Trial (MIST), we estimated the association between MD and its influential factors using logistic regression, adjusting for age, body mass index (BMI) and study area. Differences between Chinese and other ethnic groups with respect to MD were also explored with adjustment for age and BMI.
A total of 28 388 women aged 45 to 65 years, who had been screened by mammography, were enrolled in the study. Of these, 49.2% were categorized as having dense breasts (BI-RADS density 3 and 4) and 50.8% as fatty breasts (BI-RADS density 1 and 2). Postmenopausal status [odds ratio (OR) = 0.66; 95% confidence interval (CI): 0.62-0.70] and higher number of live births (OR = 0.56; 95% CI: 0.46-0.68) were inversely associated with MD, whereas prior benign breast disease (OR = 1.48; 95% CI: 1.40-1.56) and later age at first birth (OR = 1.17; 95% CI: 1.08-1.27) were positively associated with MD. In comparison with the data from the Breast Cancer Surveillance Consortium, we found that women in MIST were more likely to have fatty breasts than Americans (from the Breast Cancer Surveillance Consortium) in the older age group (≥50 years) but more likely to have dense breasts in the younger age group (<50 years).
This study suggests that several risk factors for breast cancer were associated with breast density in Chinese women. Information on the determinants of mammographic density may provide valuable insights into breast cancer aetiology.
尚未在中国女性中对乳腺X线密度（MD）进行系统研究。乳腺癌筛查项目提供了大量无症状女性的MD详细信息。
在多模态独立筛查试验（MIST）中，我们使用逻辑回归估计MD与其影响因素之间的关联，并对年龄、体重指数（BMI）和研究地区进行了校正。还在对年龄和BMI进行校正的情况下，探讨了中国女性与其他种族在MD方面的差异。
共有28388名年龄在45至65岁之间、接受过乳腺X线筛查的女性纳入本研究。其中，49.2%被归类为乳腺致密（BI-RADS密度3和4），50.8%为脂肪型乳腺（BI-RADS密度1和2）。绝经状态[比值比（OR）=0.66；95%置信区间（CI）：0.62-0.70]和较高的活产次数（OR =0.56；95%CI：0.46-0.68）与MD呈负相关，而既往良性乳腺疾病（OR =1.48；95%CI：1.40-1.56）和初产年龄较大（OR =1.17；95%CI：1.08-1.27）与MD呈正相关。与乳腺癌监测联盟的数据相比，我们发现MIST中的女性在年龄较大组（≥50岁）比美国人（来自乳腺癌监测联盟）更易有脂肪型乳腺，但在年龄较小组（<50岁）更易有致密乳腺。
本研究表明，中国女性中一些乳腺癌风险因素与乳腺密度有关。乳腺X线密度决定因素的信息可能为乳腺癌病因学提供有价值的见解。
