From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016.
Radiographics. 2018 Jul-Aug;38(4):983-996. doi: 10.1148/rg.2018180035. Epub 2018 Jun 1.
Breast density, fibroglandular tissue, and background parenchymal enhancement (BPE) are recognized independent biomarkers for breast cancer risk. For this reason, reproducibility and consistency in objective assessment of these parameters at mammography (breast density) and at magnetic resonance imaging (fibroglandular tissue and BPE) are clinically relevant. However, breast density, fibroglandular tissue, and BPE are manifestations of dynamic physiologic processes and may change in response to both endogenous and exogenous hormonal stimulation. It is therefore important for the radiologist to recognize settings in which hormonal stimulation may alter the appearance of these biomarkers at imaging and to appreciate how such changes may affect risk assessment, cancer detection, and even prognosis. The purpose of this review article is therefore to review key features and means of evaluating breast density, fibroglandular tissue, and BPE at imaging; to detail how endogenous and exogenous hormonal stimuli may affect breast density, fibroglandular tissue, and BPE, potentially affecting radiologic interpretation; and, finally, to provide an update regarding current hormone treatment guidelines and indications that may result in imaging changes through hormone modulation. RSNA, 2018.
乳腺密度、纤维腺体组织和背景实质增强（BPE）是公认的乳腺癌风险独立生物标志物。出于这个原因，在乳房 X 线摄影（乳腺密度）和磁共振成像（纤维腺体组织和 BPE）中对这些参数进行客观评估的可重复性和一致性在临床上具有重要意义。然而，乳腺密度、纤维腺体组织和 BPE 是动态生理过程的表现，可能会对内源性和外源性激素刺激产生反应而发生变化。因此，放射科医生识别可能改变这些生物标志物在影像学上表现的激素刺激情况，并了解这些变化如何影响风险评估、癌症检测甚至预后非常重要。因此，本文的目的是回顾评估乳腺密度、纤维腺体组织和 BPE 的影像学表现的关键特征和方法；详细说明内源性和外源性激素刺激如何影响乳腺密度、纤维腺体组织和 BPE，从而可能影响放射学解释；最后，提供有关当前激素治疗指南和指示的最新信息，这些信息可能通过激素调节导致影像学变化。RSNA，2018 年。
