Velásquez García Héctor A, Gotay Carolyn C, Wilson Christine M, Lohrisch Caroline A, Lai Agnes S, Aronson Kristan J, Spinelli John J
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Population Oncology, BC Cancer, Vancouver, BC, Canada.
Breast Cancer (Dove Med Press). 2019 Aug 16;11:261-271. doi: 10.2147/BCTT.S192766. eCollection 2019.
Mammographic density is an important breast cancer risk factor, although it is not clear whether the association differs across breast cancer tumor subtypes. We examined the association between indicators of mammographic density and breast cancer risk by tumor subtype among postmenopausal women by investigating heterogeneity across tumor characteristics.
Mammographic density measures were determined for 477 breast cancer cases and 588 controls, all postmenopausal, in Vancouver, British Columbia, using digitized screening mammograms and Cumulus software. Mammographic dense (DA), non-dense (NDA), and percent dense (PDA) areas were treated as continuous covariates and categorized into quartiles according to the distribution in controls. For cases only, tests for heterogeneity between tumor subtypes were assessed by multinomial logistic regression. Associations between mammographic density and breast cancer risk were modeled for each subtype separately through unconditional logistic regression.
Heterogeneity was apparent for the association of PDA with tumor size (-heterogeneity=0.04). Risk did not differ across the other assessed tumor characteristics (-heterogeneity values >0.05).
These findings do not provide strong evidence that mammographic density parameters differentially affect specific breast cancer tumor characteristics.
乳腺钼靶密度是一个重要的乳腺癌风险因素,尽管尚不清楚这种关联在不同乳腺癌肿瘤亚型中是否存在差异。我们通过研究绝经后女性肿瘤特征的异质性,来检验乳腺钼靶密度指标与不同肿瘤亚型乳腺癌风险之间的关联。
在加拿大不列颠哥伦比亚省温哥华市,使用数字化筛查乳腺钼靶片和Cumulus软件,对477例乳腺癌病例和588例对照(均为绝经后女性)进行乳腺钼靶密度测量。将乳腺钼靶致密区(DA)、非致密区(NDA)和致密百分比(PDA)面积作为连续协变量,并根据对照组的分布分为四分位数。仅针对病例,通过多项逻辑回归评估肿瘤亚型之间的异质性检验。通过无条件逻辑回归分别对每种亚型建立乳腺钼靶密度与乳腺癌风险之间的关联模型。
PDA与肿瘤大小的关联存在明显异质性(异质性=0.04)。在其他评估的肿瘤特征中风险无差异(异质性值>0.05)。
这些发现没有提供有力证据表明乳腺钼靶密度参数对特定乳腺癌肿瘤特征有不同影响。