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乳腺钼靶筛查假阳性女性的评估选择与后续乳腺癌风险

Choice of Assessment and Subsequent Risk of Breast Cancer among Women with False-Positive Mammography Screening.

作者信息

Sardini Bayan, Fogh Jørgensen Susanne, Brønsro Larsen Lisbet, Elhakim Mohammad Talal, Njor Sisse Helle

机构信息

Department of Public Health Programmes, University Research Clinic for Cancer Screening, Randers Regional Hospital, Skovlyvej 15, 8930 Randers, Denmark.

Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd. 82, 8200 Aarhus, Denmark.

出版信息

Cancers (Basel). 2023 Mar 20;15(6):1867. doi: 10.3390/cancers15061867.

Abstract

Women with false-positive mammography screening results have a two- to four-fold higher risk of breast cancer. This study aimed to investigate if the subsequent risk of breast cancer after a false-positive mammography screening is associated with the received diagnostic assessment. The study population consisted of women who underwent false-positive mammography screening from January 2010 to June 2019. They were categorised into seven groups depending on the elements in the assessment (standard care: additional mammography, ultrasound, and if they had a relevant biopsy). Risks of interval cancer, next-round screen-detected cancer, and long-term breast cancer for non-standard care assessments were compared to standard care assessments using Binomial and Cox regression models. We included 44,279 women with a false-positive result. Invasive assessments that lacked an ultrasound or additional mammography were not more associated with an increased risk of subsequent cancers compared to that of 'all three elements'. The few assessments that included 'only ultrasound' or 'only mammography' resulted in higher relative risks of next-round screen-detected cancer of 1.52 (95% CI: 0.93-2.47) and 1.67 (95% CI: 0.54-5.16), respectively, compared to that of standard care. The increased subsequent risk of breast cancer among women with a previous false-positive result was not found to be correlated with the choice of elements in the assessment process.

摘要

乳腺钼靶筛查结果为假阳性的女性患乳腺癌的风险高出两到四倍。本研究旨在调查乳腺钼靶筛查假阳性结果后乳腺癌的后续风险是否与所接受的诊断评估相关。研究人群包括2010年1月至2019年6月期间接受乳腺钼靶筛查假阳性的女性。根据评估中的要素(标准护理:额外的乳腺钼靶检查、超声检查,以及是否进行了相关活检),她们被分为七组。使用二项式和Cox回归模型,将非标准护理评估的间期癌、下一轮筛查发现的癌症和长期乳腺癌风险与标准护理评估进行比较。我们纳入了44279名结果为假阳性的女性。与“所有三项要素”相比,缺乏超声检查或额外乳腺钼靶检查的侵入性评估与后续癌症风险增加的相关性并不更高。与标准护理相比,少数仅包括“超声检查”或“乳腺钼靶检查”的评估导致下一轮筛查发现癌症的相对风险分别更高,为1.52(95%CI:0.93 - 2.47)和1.67(95%CI:0.54 - 5.16)。先前结果为假阳性的女性中乳腺癌后续风险的增加与评估过程中要素的选择无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c627/10046942/2148dc06d4e6/cancers-15-01867-g001.jpg

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