Bell R J
Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Climacteric. 2020 Oct;23(5):460-465. doi: 10.1080/13697137.2020.1785418. Epub 2020 Jul 8.
Mammographic density, which is determined by the relative amounts of fibroglandular tissue and fat in the breast, varies between women. Mammographic density is associated with a range of factors, including age and body mass index. The description of mammographic density has been transformed by the digitalization of mammography, which has allowed automation of the assessment of mammographic density, rather than using visual inspection by a radiologist. High mammographic density is important because it is associated with reduced sensitivity for the detection of breast cancer at the time of mammographic screening. High mammographic density is also associated with an elevated risk of developing breast cancer. Mammographic density appears to be on the causal pathway for some breast cancer risk factors, but not others. Mammographic density needs to be considered in the context of a woman's background risk of breast cancer. There is intense debate about the use of supplementary imaging for women with high mammographic density. Should supplementary imaging be used in women with high mammographic density and a clear mammogram? If so, what modalities of imaging should be used and in which women? Trials are underway to address the risks and benefits of supplementary imaging.
乳房X线密度由乳腺中纤维腺组织和脂肪的相对含量决定，在女性之间存在差异。乳房X线密度与一系列因素有关，包括年龄和体重指数。乳房X线摄影的数字化改变了对乳房X线密度的描述，这使得乳房X线密度评估能够自动化，而不是由放射科医生进行目视检查。高乳房X线密度很重要，因为它与乳房X线筛查时乳腺癌检测的敏感性降低有关。高乳房X线密度还与患乳腺癌的风险升高有关。乳房X线密度似乎在某些乳腺癌风险因素的因果途径中起作用，但在其他因素中并非如此。需要在女性患乳腺癌的背景风险的背景下考虑乳房X线密度。关于对乳房X线密度高的女性使用补充成像存在激烈的争论。乳房X线密度高且乳房X线片清晰的女性是否应使用补充成像？如果是，应该使用哪些成像方式以及针对哪些女性？正在进行试验以解决补充成像的风险和益处。
