Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway.
Oslo Centre for Biostatistics & Epidemiology, Oslo University Hospital, Oslo, Norway.
Acta Radiol. 2022 May;63(5):586-595. doi: 10.1177/02841851211006319. Epub 2021 Apr 22.
Mammographic features of calcifications on mammograms showing invasive breast cancer are associated with survival. Less is known about mammographic features and progression to invasive breast cancer among women treated for ductal carcinoma in situ (DCIS).
To investigate mammographic features of calcifications in screen-detected DCIS in women who later did and did not get diagnosed with invasive breast cancer.
This registry-based nested case-control study analyzed data from women with screen-detected DCIS in BreastScreen Norway, 1995-2016. Within this cohort of women with DCIS, those who were later diagnosed with invasive breast cancer (cases) were matched (1:2) to women who were not diagnosed with invasive breast cancer (controls) after their DCIS and by the end of 2016. Information on mammographic features were collected by a national radiological review, where screening mammograms were reviewed locally at each of the 16 breast centers in Norway. We used conditional logistic regression analysis to estimate associations between mammographic features of calcifications in the DCIS mammogram and the risk of subsequent invasive breast cancer.
We found a higher risk of invasive breast cancer associated with fine linear branching (casting) morphology (odds ratio 20.0; 95% confidence interval [CI] 2.5-158.9) compared to fine linear or fine pleomorphic morphology. Regional or diffuse distribution showed an odds ratio of 2.8 (95% CI 1.0-8.2) compared to segmental or linear distribution.
Mammographic features of calcifications in screen-detected DCIS were of influence on the risk of invasive breast cancer. Unfavorable characteristics of DCIS were fine linear branching morphology, and regional or diffuse distribution.
在显示浸润性乳腺癌的乳腺 X 线照片上钙化的乳腺 X 线特征与生存有关。在接受导管原位癌（DCIS）治疗的女性中，关于乳腺 X 线特征与进展为浸润性乳腺癌的相关性知之甚少。
研究在乳腺 X 线筛查中发现的 DCIS 中钙化的乳腺 X 线特征，这些女性后来是否被诊断出患有浸润性乳腺癌。
本基于注册的巢式病例对照研究分析了 1995 年至 2016 年期间在挪威乳腺 X 线筛查中发现的 DCIS 女性的数据。在这组 DCIS 女性中，那些后来被诊断为浸润性乳腺癌（病例）的女性与未被诊断为浸润性乳腺癌（对照组）的女性相匹配（1：2），并在 2016 年底结束。通过国家放射学审查收集了关于乳腺 X 线特征的信息，其中在挪威的 16 个乳腺中心的每个中心都对筛查性乳腺 X 线片进行了局部审查。我们使用条件逻辑回归分析来估计 DCIS 乳腺 X 线片中钙化的乳腺 X 线特征与随后发生浸润性乳腺癌的风险之间的关联。
我们发现，与细线性或细多形性形态相比，具有细线性分支（铸型）形态的钙化具有更高的浸润性乳腺癌风险（比值比 20.0；95%置信区间 [CI] 2.5-158.9）。与节段性或线性分布相比，区域性或弥漫性分布的比值比为 2.8（95%CI 1.0-8.2）。
在筛查中发现的 DCIS 中钙化的乳腺 X 线特征会影响浸润性乳腺癌的风险。DCIS 的不良特征是细线性分支形态和区域性或弥漫性分布。
