Mammographic Density and Risk of Contralateral Breast Cancer

乳房X光密度和对侧乳腺癌的风险

基本信息

批准号：
8717611
负责人：
JONINE L. BERNSTEIN
金额：
$ 52.06万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-19 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8717611
关键词：
Address Adipose tissue Aftercare Area Breast Breast Cancer Treatment Cancer Control Categories Chemotherapy-Oncologic Procedure Clinical Clinical Management Clinical Markers Consent Contralateral Data Diagnosis Epidemiology Estrogens Film General Population Glare Health Personnel High Risk Woman Hormonal Interview Link Malignant Neoplasms Mammographic Density Mammography Measurement Measures Medical Records Menopause Meta-Analysis Methods Modality Monitor Noninfiltrating Intraductal Carcinoma Odds Ratio Outcome Population Study Premenopause Preventive Progesterone Questionnaires Radiation Recruitment Activity Research Design Research Personnel Resources Retrieval Risk Risk Factors Risk Management Risk Marker Role Series Survivors Tamoxifen Telephone Interviews Time Tissues Variant Woman Women&apos s Health breast cancer diagnosis breast density cancer risk cancer therapy chemotherapy cost density environment related cancer epidemiology study high risk improved malignant breast neoplasm modifiable risk novel population based programs response screening

项目摘要

DESCRIPTION (provided by applicant): Mammographic density (MD) is a well-established and strong risk factor for first primary breast cancer. Women with invasive cancer in one breast are at 2-5 times higher risk of developing a contralateral breast cancer (CBC) compared to the general population risk of a first primary breast cancer. We and other researchers have shown that the treatment a woman receives for her first primary can alter her risk of developing CBC. Studies show MD is altered in response to some hormonal and other treatments, increasing with menopausal estrogen and progesterone therapy, and decreasing with tamoxifen, an anti-hormonal treatment as well as chemotherapy. It is plausible that MD, both before and after treatment, may be useful clinical markers of risk of CBC in women with a first primary breast cancer. As a result of improved screening and treatment, there are increasing numbers of survivors of breast cancer. However, there are few known clinical determinants of subsequent CBC, limiting women and health care providers in the assessment and management of this risk. The ongoing Women's Environmental, Cancer, and Radiation Epidemiology (WECARE) II Study is a population-based study of 800 CBC cases and 800 unilateral breast cancer (UBC) controls currently being recruited and interviewed, along with having their breast cancer diagnosis and treatment medical records reviewed. We now propose to: retrieve mammograms taken at, or within a year prior to, the first breast cancer diagnosis and those at 12-18 months following diagnosis; digitize film mammograms; and quantitatively assess MD using both the well-established standard thresholding method (Cumulus) and a novel automated density measure (Variation or "V"). Our Primary Specific Aims are: 1. To estimate the relationship between MD (both %MD and absolute dense area, using the Cumulus thresholding program) of the contralateral breast around the time of the first diagnosis (at or up to one year prior) and the rik of a subsequent diagnosis of CBC invasive breast cancer in the contralateral breast; 2. To estimate the relationship between MD (both %MD and dense area, using Cumulus) of the contralateral breast at 12-18 months following initial diagnosis (when initial chemotherapy and radiation treatments are likely completed) and the risk of a subsequent diagnosis of invasive breast cancer in the contralateral breast; and 3. To assess changes in MD of the contralateral breast before and after treatment (and/or after initiation of hormonal treatment) by treatment modality. Our Secondary Specific Aims are: 1. To estimate whether change in MD (%MD or dense area) of the contralateral breast before and after treatment is associated with risk of a subsequent diagnosis of invasive breast cancer in the contralateral breast; 2.To address the above Aims using V, an automated, validated, breast density measurement and compare results with those derived from the Cumulus measure. The novel study we propose could be useful for identifying women at high risk of CBC and it addresses an understudied issue that is of high clinical importance to the many women who survive their first primary breast cancer.

描述（由申请人提供）：乳腺X线摄影密度（MD）是初次乳腺癌的良好且强大的危险因素。与第一次原发性乳腺癌的一般人群风险相比，一种乳腺癌侵入性癌的女性患对侧乳腺癌（CBC）的风险高2-5倍。我们和其他研究人员表明，女性为她的第一个初选获得的治疗方法可以改变她患CBC的风险。研究表明，MD会因某些激素和其他治疗而改变，随着绝经性雌激素和孕酮治疗的增加，以及他莫昔芬（一种抗激素治疗以及化学疗法）的降低。医学博士在治疗前后都可能是第一次原发性乳腺癌女性中CBC风险的有用临床标志。由于筛查和治疗的改善，乳腺癌的幸存者数量越来越多。但是，随后的CBC几乎没有已知的临床决定因素，将妇女和医疗保健提供者限制在对此风险的评估和管理中。正在进行的妇女环境，癌症和放射流行病学（WECARE）II研究是一项基于人群的研究，对目前正在招募和采访的800例CBC病例和800例单侧乳腺癌（UBC）对照，以及对其乳腺癌诊断和治疗医疗记录进行了审查。我们现在建议：检索第一次乳腺癌诊断或诊断后12-18个月的乳腺癌诊断或前一年内拍摄的乳房X线照片；数字化膜乳房X线照片；并使用良好的标准阈值方法（Cumulus）和新型的自动密度度量（变异或“ V”）进行定量评估MD。我们的主要具体目的是：1。估计对对诊断（或最多在前一年）和对核心外侧乳房中CBC乳腺癌的随后诊断的对比乳房（在或最多一年之前），对对诊断（或最多最多一年的RIK）估计对对乳腺的MD（％MD和绝对致密区域）之间的关系； 2。为了估计初次诊断后12-18个月的MD（％MD和致密面积，使用积云）（当最初的化学疗法和放射治疗可能完成时）和随后诊断出对侧乳腺内入侵性乳腺癌的风险；和3。通过治疗方式在治疗前后（和/或激素治疗开始）之前和/或之后的对侧乳房的MD变化。我们的次要特定目的是：1。估计治疗前后对侧乳腺的MD（％MD或致密区域）是否与随后诊断为对侧乳腺癌的浸润性乳腺癌的风险有关； 2.使用V解决上述目的，该目标是自动化，经过验证的乳房密度测量，并将结果与源自积分量的结果进行比较。我们提出的新型研究对于识别有CBC高风险的女性可能很有用，它解决了一个研究的问题，该问题对于许多在第一次原发性乳腺癌中生存的妇女具有很高的临床重要性。