中国乳腺癌患者的乳腺密度定量测量值与终末导管小叶单位退化的相关性。

Associations between quantitative measures of mammographic density and terminal ductal lobular unit involution in Chinese breast cancer patients.

机构信息

Division of Cancer Epidemiology and Genetics, DHHS, National Cancer Institute, NIH, 9609 Medical Center Drive, Bethesda, MD, 20892-9761, USA.

National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

出版信息

Breast Cancer Res. 2024 Jul 15;26(1):116. doi: 10.1186/s13058-024-01856-z.

DOI:10.1186/s13058-024-01856-z

PMID:39010116

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11247848/

Abstract

BACKGROUND

Higher mammographic density (MD), a radiological measure of the proportion of fibroglandular tissue in the breast, and lower terminal duct lobular unit (TDLU) involution, a histological measure of the amount of epithelial tissue in the breast, are independent breast cancer risk factors. Previous studies among predominantly white women have associated reduced TDLU involution with higher MD.

METHODS

In this cohort of 611 invasive breast cancer patients (ages 23-91 years [58.4% ≥ 50 years]) from China, where breast cancer incidence rates are lower and the prevalence of dense breasts is higher compared with Western countries, we examined the associations between TDLU involution assessed in tumor-adjacent normal breast tissue and quantitative MD assessed in the contralateral breast obtained from the VolparaDensity software. Associations were estimated using generalized linear models with MD measures as the outcome variables (log-transformed), TDLU measures as explanatory variables (categorized into quartiles or tertiles), and adjusted for age, body mass index, parity, age at menarche and breast cancer subtype.

RESULTS

We found that, among all women, percent dense volume (PDV) was positively associated with TDLU count (highest tertile vs. zero: Exp = 1.28, 95% confidence interval [CI] 1.08-1.51, p = < .0001), TDLU span (highest vs. lowest tertile: Exp = 1.23, 95% CI 1.11-1.37, p = < .0001) and acini count/TDLU (highest vs. lowest tertile: Exp = 1.22, 95% CI 1.09-1.37, p = 0.0005), while non-dense volume (NDV) was inversely associated with these measures. Similar trend was observed for absolute dense volume (ADV) after the adjustment of total breast volume, although the associations for ADV were in general weaker than those for PDV. The MD-TDLU associations were generally more pronounced among breast cancer patients ≥ 50 years and those with luminal A tumors compared with patients < 50 years and with luminal B tumors.

CONCLUSIONS

Our findings based on quantitative MD and TDLU involution measures among Chinese breast cancer patients are largely consistent with those reported in Western populations and may provide additional insights into the complexity of the relationship, which varies by age, and possibly breast cancer subtype.

摘要

背景

更高的乳房 X 光密度（MD），一种乳房中纤维腺体组织比例的放射学测量，以及更低的终末导管小叶单位（TDLU）退化，一种乳房上皮组织量的组织学测量，都是独立的乳腺癌危险因素。以前在主要为白人女性的研究中，发现 TDLU 退化与较高的 MD 有关。

方法

在这项来自中国的 611 名浸润性乳腺癌患者（年龄 23-91 岁[58.4%≥50 岁]）的队列研究中，我们检查了肿瘤旁正常乳腺组织中评估的 TDLU 退化与从 VolparaDensity 软件获得的对侧乳腺的定量 MD 之间的关系。使用广义线性模型，将 MD 测量值作为因变量（对数转换），将 TDLU 测量值作为解释变量（分类为四分位数或三分位数），并根据年龄、体重指数、产次、初潮年龄和乳腺癌亚型进行调整。

结果

我们发现，在所有女性中，致密百分比（PDV）与 TDLU 计数呈正相关（最高三分位与零位相比：Exp=1.28，95%置信区间[CI]1.08-1.51，p<0.0001），TDLU 跨度（最高与最低三分位相比：Exp=1.23，95%CI 1.11-1.37，p<0.0001）和腺泡计数/TDLU（最高与最低三分位相比：Exp=1.22，95%CI 1.09-1.37，p=0.0005），而非致密体积（NDV）与这些测量值呈负相关。调整总乳腺体积后，绝对致密体积（ADV）也观察到类似的趋势，尽管 ADV 的关联总体上弱于 PDV。在≥50 岁的乳腺癌患者和 luminal A 型肿瘤患者中，MD-TDLU 之间的关联比<50 岁的患者和 luminal B 型肿瘤患者更明显。