van Gils C H, Otten J D, Verbeek A L, Hendriks J H
Department of Epidemiology, University of Nijmegen, The Netherlands.
Br J Radiol. 1995 Oct;68(814):1133-5. doi: 10.1259/0007-1285-68-814-1133.
In studies on mass screening, it has often been reported that tumours in breasts with dense parenchyma are difficult to detect and may have a more advanced stage at diagnosis. Shorter rescreening intervals have been suggested for these women but, before recommending such a strategy, it is important to investigate how often dense breast parenchyma (P2 and DY patterns according to Wolfe) is actually present in a screening population and to what extent these patterns change with age. The prevalence of dense breast parenchyma (P2 and DY) in our study population was 33% at first examination (n = 2581), which is fairly low compared with other screening populations. Its presence was strongly, inversely age-dependent. Breast patterns of 1177 women, aged 35-85 years, were followed for 12 years. In 39% (182/461) of the women with a P2 or DY pattern at their first examination, regression to a lucent pattern (N1 and P1) occurred over the years. The majority of these women were assumed to have reached menopause in the follow-up period. These findings support the hypothesis that the presence of dense breast parenchyma is related to the reproductive period and indicate that shortening the rescreening intervals would be most effective in pre-menopausal age groups.
在大规模筛查研究中,经常有报告称,实质致密的乳房中的肿瘤难以检测,且在诊断时可能处于更晚期阶段。有人建议对这些女性缩短复查间隔时间,但是,在推荐这样的策略之前,重要的是要调查在筛查人群中致密乳腺实质(根据沃尔夫分类为P2和DY型)实际出现的频率,以及这些类型随年龄变化的程度。在我们的研究人群中,初次检查时致密乳腺实质(P2和DY型)的患病率为33%(n = 2581),与其他筛查人群相比相当低。其出现与年龄呈强烈的负相关。对1177名年龄在35至85岁之间的女性的乳房类型进行了12年的随访。在初次检查时具有P2或DY型的女性中,39%(182/461)在随后几年中转变为透亮型(N1和P1)。这些女性中的大多数在随访期间被认为已绝经。这些发现支持了致密乳腺实质的出现与生育期有关的假设,并表明缩短复查间隔时间在绝经前年龄组中最为有效。