Lee Su Hyun, Ryu Han-Suk, Jang Myoung-Jin, Yi Ann, Ha Su Min, Kim Soo-Yeon, Chang Jung Min, Cho Nariya, Moon Woo Kyung
From the Departments of Radiology (S.H.L., S.M.H., S.Y.K., J.M.C., N.C., W.K.M.) and Pathology (H.S.R.), College of Medicine, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea (M.J.J.); and Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea (A.Y.).
Radiology. 2021 Oct;301(1):57-65. doi: 10.1148/radiol.2021210367. Epub 2021 Jul 20.
Background Breast density at mammography is an established risk factor for breast cancer, but it cannot be used to distinguish between glandular and fibrous tissue. Purpose To evaluate the association between the glandular tissue component (GTC) at screening breast US and the risk of future breast cancer in women with dense breasts and the association between the GTC and lobular involution. Materials and Methods Screening breast US examinations performed in women with no prior history of breast cancer and with dense breasts with negative findings from mammography from January 2012 to December 2015 were retrospectively identified. The GTC was reported as being minimal, mild, moderate, or marked at the time of the US examination. In women who had benign breast biopsy results, the degree of lobular involution in normal background tissue was categorized as not present, mild, moderate, or complete. The GTC-related breast cancer risk in women with a cancer diagnosis or follow-up after 6 months was estimated by using Cox proportional hazards regression. Cumulative logistic regression was used to evaluate the association between the GTC and lobular involution. Results Among 8483 women (mean age, 49 years ± 8 [standard deviation]), 137 developed breast cancer over a median follow-up time of 5.3 years. Compared with a minimal or mild GTC, a moderate or marked GTC was associated with an increased cancer risk (hazard ratio, 1.5; 95% CI: 1.05, 2.1; = .03) after adjusting for age and breast density. The GTC had an inverse association with lobular involution; women with no, mild, or moderate involution had greater odds (odds ratios of 4.9 [95% CI: 1.5, 16.6], 2.6 [95% CI: 0.95, 7.2], and 1.8 [95% CI: 0.7, 4.6], respectively) of a moderate or marked GTC than those with complete involution ( = .004). Conclusion The glandular tissue component was independently associated with the future breast cancer risk in women with dense breasts and reflects the lobular involution. It should be considered for risk stratification during screening breast US. © RSNA, 2021
乳腺钼靶检查中的乳腺密度是乳腺癌的既定风险因素，但它无法用于区分腺性组织和纤维组织。目的：评估乳腺超声筛查时的腺性组织成分（GTC）与乳腺致密女性未来患乳腺癌风险之间的关联，以及GTC与小叶退化之间的关联。材料与方法：回顾性纳入2012年1月至2015年12月期间接受乳腺超声筛查的女性，这些女性无乳腺癌病史，乳腺致密且乳腺钼靶检查结果为阴性。超声检查时，GTC报告为极少、轻度、中度或显著。在乳腺活检结果为良性的女性中，正常背景组织的小叶退化程度分为无、轻度、中度或完全退化。使用Cox比例风险回归估计癌症诊断或6个月随访后女性中与GTC相关的乳腺癌风险。累积逻辑回归用于评估GTC与小叶退化之间的关联。结果：在8483名女性（平均年龄49岁±8[标准差]）中，在中位随访时间5.3年期间有137名患乳腺癌。在调整年龄和乳腺密度后，与极少或轻度GTC相比，中度或显著GTC与癌症风险增加相关（风险比，1.5；95%CI：1.05，2.1；P = .03）。GTC与小叶退化呈负相关；与完全退化的女性相比，无、轻度或中度退化的女性出现中度或显著GTC的几率更高（几率比分别为4.9[95%CI：1.5，16.6]、2.6[95%CI：0.95，7.2]和1.8[95%CI：0.7，4.6]；P = .004）。结论：腺性组织成分与乳腺致密女性未来患乳腺癌风险独立相关，并反映小叶退化情况。在乳腺超声筛查期间应考虑将其用于风险分层。©RSNA，2021
