JAMA :数字乳腺断层合成X线成像技术对间隔浸润性和晚期乳腺癌发病风险的影响

2022-06-19 zhangfan MedSci原创

与常规乳腺X光检查相比,DBT筛查不能降低间隔浸润性乳腺癌风险,对于占总人数3.6%的致密型乳腺且乳腺癌高风险女性,DBT可降低晚期乳腺癌风险,但其他人群中DBT无明显优势


数字乳腺断层合成X线成像技术(DBT)可显著提高致密型乳腺女性人群乳腺癌检出率,2021年美国81%的女性乳腺癌筛查使用了DBT。近日研究人员比较DBT vs 常规乳腺X光检查对间隔浸润性和晚期乳腺癌发病风险的影响。

BCSC研究中,504427 名40-79岁的女性,在2011-2018年间,在44个美国研究中心接受了1003900 次乳腺X光筛查和375189 次DBT检查,记录受筛查人群的乳腺密度,乳腺癌诊断随访至2019年。研究的主要终点是筛查后12个月内间隔浸润性癌和晚期乳腺癌。

参与者接受筛查时平均年龄为58岁。DBT组与乳腺X光检查组相比,每1000次检查的间隔浸润性癌风险没有显著差异(0.57 vs 0.61),筛查后中低风险人群的5年乳腺癌风险低于1.67%,但致密型乳腺人群的5年乳腺癌风险高于1.67%。在中低风险人群,几乎完全脂肪、多量纤维腺体型乳腺或乳腺密度不均的高危人群中,DBT与X光检查相比,组间晚期乳腺癌发病率没有显著差异。对于乳腺密度极高且乳腺癌风险较高的女性(占总人数的3.6%),DBT与X光检查相比,每1000次检查中,DBT组晚期乳腺癌发生率明显较低(DBT组检查13291 次,X光检查组检查31300 次;每1000次检出率0.27 vs 0.80;差异−0.53),但对于其他人群,DBT的优势不显著(DBT组10611 次,X光检查组37796次;每1000次检出率0.54 vs 0.42次;差异0.12)。

组间乳腺癌、间隔浸润性乳腺癌以及晚期乳腺癌风险差异

研究认为,与常规乳腺X光检查相比,DBT筛查不能降低间隔浸润性乳腺癌风险,对于占总人数3.6%的致密型乳腺且乳腺癌高风险女性,DBT可降低晚期乳腺癌风险,但其他人群中DBT无明显优势

原始出处:

Karla Kerlikowske et al. Association of Screening With Digital Breast Tomosynthesis vs Digital Mammography With Risk of Interval Invasive and Advanced Breast Cancer. JAMA .June 14, 2022

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1799925, encodeId=f0d31e999255d, content=<a href='/topic/show?id=9e3fe127909' target=_blank style='color:#2F92EE;'>#癌发病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71279, encryptionId=9e3fe127909, topicName=癌发病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2c92500045, createdName=12498636m49(暂无昵称), createdTime=Fri Jan 06 19:13:09 CST 2023, time=2023-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1231960, encodeId=e14012319603f, content=亚洲人群以偏致密型多,会有什么样的结果呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b0bb5745182, createdName=ms2000000957076805, createdTime=Tue Jul 12 10:24:37 CST 2022, time=2022-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1298071, encodeId=435612980e15c, content=<a href='/topic/show?id=c42d18892ad' target=_blank style='color:#2F92EE;'>#X线#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18892, encryptionId=c42d18892ad, topicName=X线)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c64275, createdName=piaojinhua, createdTime=Fri Jun 17 12:13:09 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570772, encodeId=c4a915e077295, content=<a href='/topic/show?id=03d55395183' target=_blank style='color:#2F92EE;'>#成像技术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53951, encryptionId=03d55395183, topicName=成像技术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d6b515702368, createdName=photoman, createdTime=Fri Jun 17 12:13:09 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1243559, encodeId=312112435596f, content=JAMA上文章都是顶级的,谢谢梅斯及时上新, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Thu Jun 16 00:13:09 CST 2022, time=2022-06-16, status=1, ipAttribution=)]
    2022-07-12 ms2000000957076805

    亚洲人群以偏致密型多,会有什么样的结果呢?

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1799925, encodeId=f0d31e999255d, content=<a href='/topic/show?id=9e3fe127909' target=_blank style='color:#2F92EE;'>#癌发病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71279, encryptionId=9e3fe127909, topicName=癌发病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2c92500045, createdName=12498636m49(暂无昵称), createdTime=Fri Jan 06 19:13:09 CST 2023, time=2023-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1231960, encodeId=e14012319603f, content=亚洲人群以偏致密型多,会有什么样的结果呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b0bb5745182, createdName=ms2000000957076805, createdTime=Tue Jul 12 10:24:37 CST 2022, time=2022-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1298071, encodeId=435612980e15c, content=<a href='/topic/show?id=c42d18892ad' target=_blank style='color:#2F92EE;'>#X线#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18892, encryptionId=c42d18892ad, topicName=X线)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c64275, createdName=piaojinhua, createdTime=Fri Jun 17 12:13:09 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570772, encodeId=c4a915e077295, content=<a href='/topic/show?id=03d55395183' target=_blank style='color:#2F92EE;'>#成像技术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53951, encryptionId=03d55395183, topicName=成像技术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d6b515702368, createdName=photoman, createdTime=Fri Jun 17 12:13:09 CST 2022, time=2022-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1243559, encodeId=312112435596f, content=JAMA上文章都是顶级的,谢谢梅斯及时上新, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Thu Jun 16 00:13:09 CST 2022, time=2022-06-16, status=1, ipAttribution=)]
    2022-06-17 piaojinhua
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    2022-06-16 肿瘤克星

    JAMA上文章都是顶级的,谢谢梅斯及时上新

    0

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