Holen Åsne S, Larsen Marthe, Moshina Nataliia, Wåade Gunvor G, Sechopoulos Ioannis, Hanestad Berit, Tøsdal Linn, Hofvind Solveig
Cancer Registry of Norway, Section for Breast Cancer Screening, Oslo, Norway.
Oslo Metropolitan University, Department of Life Sciences and Health, Oslo, Norway.
J Breast Imaging. 2021 Aug 12;3(4):427-437. doi: 10.1093/jbi/wbab042.
To investigate whether having the nipple imaged in profile was associated with breast characteristics or compression parameters, and whether it affected selected outcomes in screening with standard digital mammography or digital breast tomosynthesis.
In this IRB-approved retrospective study, results from 87 450 examinations (174 900 breasts) performed as part of BreastScreen Norway, 2016-2019, were compared by nipple in profile status and screening technique using descriptive statistics and generalized estimating equations. Unadjusted and adjusted odds ratios with 95% confidence intervals (95% CIs) were estimated for outcomes of interest, including age, breast volume, volumetric breast density, and compression force as covariates.
Achieving the nipple in profile versus not in profile was associated with lower breast volume (845.1 cm3 versus 1059.9 cm3, P < 0.01) and higher mammographic density (5.6% versus 4.4%, P < 0.01). Lower compression force and higher compression pressure were applied to breasts with the nipple in profile (106.6 N and 11.5 kPa) compared to the nipple not in profile (110.8 N and 10.5 kPa, P < 0.01 for both). The adjusted odds ratio was 0.95 (95% CI: 0.88-1.02; P = 0.15) for recall and 0.92 (95% CI: 0.77-1.10; P = 0.36) for screen-detected cancer for nipple in profile versus not in profile.
Breast characteristics and compression parameters might hamper imaging of the nipple in profile. However, whether the nipple was in profile or not on the screening mammograms did not influence the odds of recall or screen-detected cancer, regardless of screening technique.
探讨乳头侧位成像是否与乳房特征或压迫参数相关，以及其是否会影响标准数字化乳腺摄影或数字乳腺断层合成筛查中的选定结果。
在这项经机构审查委员会批准的回顾性研究中，将2016 - 2019年挪威乳腺筛查项目中87450次检查（174900侧乳房）的结果，根据乳头侧位状态和筛查技术，采用描述性统计和广义估计方程进行比较。以年龄、乳房体积、乳腺体积密度和压迫力作为协变量，对感兴趣的结果估计未调整和调整后的比值比及95%置信区间（95%CI）。
乳头呈侧位与未呈侧位相比，乳房体积较小（845.1立方厘米对1059.9立方厘米，P < 0.01），乳腺X线摄影密度较高（5.6%对4.4%，P < 0.01）。与乳头未呈侧位的乳房相比，乳头呈侧位的乳房所施加的压迫力较低，压迫压力较高（分别为106.6牛和11.5千帕，以及110.8牛和10.5千帕，两者P均< 0.01）。乳头呈侧位与未呈侧位相比，召回的调整后比值比为0.95（95%CI：0.88 - 1.02；P = 0.15），筛查发现癌症的调整后比值比为0.92（95%CI：0.77 - 1.10；P = 0.36）。
乳房特征和压迫参数可能会妨碍乳头侧位成像。然而，无论筛查技术如何，筛查乳腺X线摄影中乳头是否呈侧位并不影响召回或筛查发现癌症的几率。
