Nevler Avinoam, Shabtai Esther, Rosin Danny, Hoffman Aviad, Gutman Mordechai, Shabtai Moshe
Isr Med Assoc J. 2016 Jan;18(1):32-5.
High density breast mammography has been associated with a greater risk for breast cancer and an increased likelihood of false negative results.
To assess whether the degree of mammographic breast density correlates with increased risk for the presence of radiographic findings requiring further histological investigation.
Included in the study were 2760 consecutive screening mammograms performed in a large volume, early detection mammography unit. All mammograms were complemented by high resolution ultrasound and interpreted by a single expert radiologist. Breast density (BD) was evaluated using a semi-quantitative 5 grade scale and grouped into low breast density (LBD) and high breast density (HBD) mammograms. Demographic and all relevant obstetric, personal and family history of breast cancer data were recorded.
Of the 2760 mammograms 2096 (76%) were LBD and 664 (24%) were HBD. Mean age of the LBD and HBD groups was 59 ± 10.5 and 50.9 ± 9.3 years respectively (P = 0001). Breast density significantly correlated with presence of mammographic findings requiring further histological assessment (8.7% and 12.3% for LBD and HBD respectively, P < 0.01). In women younger than 60 years in whom histological assessment was required due to these findings, malignant pathology was significantly more prevalent in the HBD group (2.3% and 4.1% respectively, P = 0.03). Age, parity, patient history and HBD were identified as independent risk factors for any pathological mammographic finding.
Highly dense mammography, aside from being an indicator of higher risk for breast cancer, appears to be associated with a significantly higher incidence of findings that will prompt further investigation to achieve a definite diagnosis.
乳腺钼靶高密度成像与患乳腺癌的风险增加以及假阴性结果的可能性增大有关。
评估乳腺钼靶密度程度是否与需要进一步组织学检查的影像学表现的风险增加相关。
该研究纳入了在一个大容量早期检测乳腺钼靶检查单位连续进行的2760例乳腺钼靶筛查。所有乳腺钼靶检查均辅以高分辨率超声，并由一名专家放射科医生进行解读。使用半定量5级量表评估乳腺密度（BD），并将乳腺钼靶图像分为低乳腺密度（LBD）和高乳腺密度（HBD）。记录人口统计学以及所有相关的乳腺癌产科、个人和家族病史数据。
在2760例乳腺钼靶检查中，2096例（76%）为LBD，664例（24%）为HBD。LBD组和HBD组的平均年龄分别为59±10.5岁和50.9±9.3岁（P = 0.001）。乳腺密度与需要进一步组织学评估的钼靶检查结果显著相关（LBD和HBD分别为8.7%和12.3%，P < 0.01）。在因这些检查结果而需要进行组织学评估的60岁以下女性中，HBD组的恶性病理情况明显更为普遍（分别为2.3%和4.1%，P = 0.03）。年龄、产次、患者病史和HBD被确定为任何钼靶病理检查结果的独立危险因素。
除了是乳腺癌高风险的指标外，乳腺钼靶高密度成像似乎还与显著更高的检查结果发生率相关，这些结果将促使进一步检查以获得明确诊断。
