Moshina Nataliia, Sebuødegård Sofie, Hofvind Solveig
Cancer Registry of Norway, P.O. 5313, Majorstuen, 0304, Oslo, Norway.
Faculty of Health Science, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Breast Cancer Res Treat. 2017 Jun;163(3):605-613. doi: 10.1007/s10549-017-4214-8. Epub 2017 Mar 29.
We aimed to investigate early performance measures in a population-based breast cancer screening program stratified by compression force and pressure at the time of mammographic screening examination. Early performance measures included recall rate, rates of screen-detected and interval breast cancers, positive predictive value of recall (PPV), sensitivity, specificity, and histopathologic characteristics of screen-detected and interval breast cancers.
Information on 261,641 mammographic examinations from 93,444 subsequently screened women was used for analyses. The study period was 2007-2015. Compression force and pressure were categorized using tertiles as low, medium, or high. χ test, t tests, and test for trend were used to examine differences between early performance measures across categories of compression force and pressure. We applied generalized estimating equations to identify the odds ratios (OR) of screen-detected or interval breast cancer associated with compression force and pressure, adjusting for fibroglandular and/or breast volume and age.
The recall rate decreased, while PPV and specificity increased with increasing compression force (p for trend <0.05 for all). The recall rate increased, while rate of screen-detected cancer, PPV, sensitivity, and specificity decreased with increasing compression pressure (p for trend <0.05 for all). High compression pressure was associated with higher odds of interval breast cancer compared with low compression pressure (1.89; 95% CI 1.43-2.48).
High compression force and low compression pressure were associated with more favorable early performance measures in the screening program.
我们旨在调查在基于人群的乳腺癌筛查项目中，根据乳腺钼靶筛查检查时的压迫力和压力进行分层的早期性能指标。早期性能指标包括召回率、筛查发现的乳腺癌和间期乳腺癌的发生率、召回的阳性预测值（PPV）、敏感性、特异性，以及筛查发现的乳腺癌和间期乳腺癌的组织病理学特征。
对93444名随后接受筛查的女性的261641次乳腺钼靶检查信息进行分析。研究期间为2007年至2015年。压迫力和压力按三分位数分为低、中、高。使用χ检验、t检验和趋势检验来检查不同压迫力和压力类别之间早期性能指标的差异。我们应用广义估计方程来确定与压迫力和压力相关的筛查发现或间期乳腺癌的比值比（OR），并对纤维腺体和/或乳房体积以及年龄进行调整。
随着压迫力增加，召回率降低，而PPV和特异性增加（所有趋势p<0.05）。随着压迫压力增加，召回率增加，而筛查发现的癌症发生率、PPV、敏感性和特异性降低（所有趋势p<0.05）。与低压迫压力相比，高压迫压力与间期乳腺癌的较高几率相关（1.89；95%CI 1.43-2.48）。
在筛查项目中，高压迫力和低压迫压力与更有利的早期性能指标相关。
