Physical Examination Center, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China.
Department of Ultrasound, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China.
Br J Radiol. 2023 Aug;96(1148):20220051. doi: 10.1259/bjr.20220051. Epub 2023 May 25.
To investigate the correlation between the risk of breast cancer for high-risk females and the density and background parenchymal enhancement (BPE) on contrast-enhanced spectral mammography (CESM).
Females at high-risk, without breast cancer history and received CESM from July 2016 to December 2017 were retrospectively enrolled. The longest follow-up time was 4.5 years, and patients who developed breast cancer with maximized follow-up time were classified as cancer cohort, while females who did not develop breast cancer were categorized as control cohort. These two cohorts were one-to-one matched in age, family and/or genetic history of breast cancer, menopausal status and status. The density and BPE at CESM imaging were assessed. Conditional logistic regression was applied to evaluate the relationship between imaging features and breast cancer risk.
During the follow-up interval, 90 women at high-risk without history of breast cancer were newly diagnosed. Compared with minimal BPE, increasing BPE levels were associated with the risk of breast cancer among high-risk females in a time interval of 4.5 years (mild: odds ratio [OR]=3.2, = 0.001; moderate: OR = 4.0, = 0.002; marked: OR = 11.2, < 0.001). In addition, females with mild, moderate or marked BPE were four times more likely to be diagnosed with breast cancer than females with minimal BPE in a time interval of 4.5 years (OR = 4.0, < 0.001).
Qualitative CESM BPE assessment may be useful in the prediction of breast cancer risk among high-risk females.
• Qualitative CESM BPE assessment may be useful in the prediction of breast cancer risk among high-risk women during the follow-up period of 4.5 years. • The significance of breast density as an independent risk factor is not fully established for high-risk women during the follow-up period of 4.5 years.
研究高危女性乳腺癌风险与对比增强光谱乳腺摄影（CESM）密度和背景实质增强（BPE）之间的相关性。
回顾性纳入 2016 年 7 月至 2017 年 12 月期间接受 CESM 检查且无乳腺癌病史的高危女性。最长随访时间为 4.5 年，随访时间最长且发生乳腺癌的患者被归类为癌症队列，而未发生乳腺癌的女性被归类为对照组。这两个队列在年龄、家族和/或乳腺癌遗传史、绝经状态和状态方面按 1:1 匹配。评估 CESM 成像的密度和 BPE。应用条件逻辑回归评估成像特征与乳腺癌风险之间的关系。
在随访期间，90 名无乳腺癌病史的高危女性被新诊断为乳腺癌。与最小 BPE 相比，在 4.5 年的时间间隔内，BPE 水平增加与高危女性乳腺癌风险相关（轻度：比值比[OR]=3.2， = 0.001；中度：OR = 4.0， = 0.002；显著：OR = 11.2， < 0.001）。此外，在 4.5 年的时间间隔内，BPE 轻度、中度或显著的女性比 BPE 最小的女性诊断出乳腺癌的可能性高 4 倍（OR = 4.0， < 0.001）。
定性 CESM BPE 评估可能有助于预测高危女性的乳腺癌风险。
•定性 CESM BPE 评估可能有助于预测高危女性在 4.5 年随访期间的乳腺癌风险。•在 4.5 年的随访期间，乳腺密度作为独立危险因素对高危女性的意义尚未完全确立。
