Integrating Mammograms in Analyses of Genes and Environment in Sisters (IMAGES)

将乳房 X 光检查融入姐妹基因和环境分析中（图像）

基本信息

批准号：
9235542
负责人：
Parisa Tehranifar
金额：
$ 49.01万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-02-06 至 2021-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9235542
关键词：
Address Affect Age Area Behavior Therapy Breast Breast Cancer Model Breast Cancer Risk Assessment Tool Breast Cancer Risk Factor Breast Cancer Surveillance Consortium CA-125 Antigen Categories Cessation of life Chemoprevention Clinical Clinical assessments Cohort Studies Data Diagnosis Discrimination Enrollment Environment Epidemiology Exposure to Family Family Cancer History Family history of First Degree Relative Frequencies Genes Genetic Genetic Markers Genetic screening method Genetic study Heterogeneity High Risk Woman Incidence Individual Intervention Investigation Life Magnetic Resonance Imaging Malignant Neoplasms Malignant neoplasm of ovary Mammographic Density Mammography Mastectomy Measurement Measures Menopause Methods Modeling Monitor Nature Operative Surgical Procedures Ovariectomy Performance Population Postmenopause Premenopause Prevention program Prevention strategy Preventive Preventive Intervention Preventive care Probability Prospective cohort Puerto Rican Radiology Specialty Recommendation Recording of previous events Relative Risks Research Retrieval Risk Risk Assessment Risk Estimate Risk Factors Risk stratification Sister Standardization Statistical Models Statutes and Laws Surveillance Program Time Tissues Woman base cancer risk case control clinical decision-making clinical practice clinical risk cost design experience follow-up improved malignant breast neoplasm predictive modeling prospective rate of change screening success

项目摘要

ABSTRACT Accurate breast cancer risk assessment has the potential to distinguish women at higher risk who need enhanced screening, preventive or risk-reducing therapies and surgeries from women at lower risk who can be spared interventions that yield little benefit and may cause harm. Breast cancer risk assessment is currently hampered by limited precision and accuracy of existing risk prediction models. Women with a family history of breast (FHBC) have the greatest need for better risk assessment as they often receive the same clinical recommendations despite substantial heterogeneity in the underlying risk by the extent of FHBC. Integration of mammographic breast density (MBD), a strong and readily assessable risk factor for breast cancer, in combination with detailed FHBC data, offers an exceptional opportunity for enhancing existing risk assessment methods. MBD generally declines with age, but the rate of change varies considerably between women, and may be particularly important to breast cancer risk; we have demonstrated that women who remain at high MBD over time are more likely to be diagnosed with breast cancer than women whose MBD decreases. Attempts to improve risk prediction models by incorporating MBD has had limited success as studies have used one-time measures of MBD and included mostly postmenopausal women for whom the largest changes in MBD may have already occurred. We propose to investigate within-individual changes in MBD over a 10- year period in relation to incident breast cancer by the extent of FHBC (Aim 1), and evaluate how changes in MBD may improve several clinical risk prediction models (Aim 2) and clinical risk stratification forming the basis for risk-based surveillance and preventive care (Aim 3). We will address these aims by building upon the U.S. Sister Study, a prospective cohort of 50,884 women with one or more sisters diagnosed with breast cancer who were personally breast cancer-free at enrollment in 2003-2009; active annual follow-up is conducted for at least 10 years with each woman. Using a nested case-control design, we will retrieve existing mammograms for all incident breast cancer cases diagnosed at ages ≤ 60 years (n=1,242 cases to date) and controls matched on age and enrollment year (2 controls selected per case at the time of case identification). We will undertake a comprehensive assessment of MBD, using both clinically available qualitative measures used in clinical practice, and assessing quantitative measures that allow for measurement of smaller changes and different components of MBD (e.g., dense, nondense tissue) that are independently associated with breast cancer risk. Our team’s experience in leading studies of MBD and prospective available data in the Sister Study will afford an unparalleled investigation of prospective MBD changes in relation to breast cancer risk, modifiable and genetic factors, and how to use this information to enhance risk assessment in women with FHBC. These results are necessary to inform personalized risk-based surveillance and prevention programs.

抽象的准确的乳腺癌风险评估有可能区分需要更高风险的女性增强筛查，预防性或降低风险的疗法和妇女的手术可能会较低宽松的干预措施几乎没有收益，可能会造成伤害。目前正在乳腺癌风险评估被现有风险预测模型的精确度和准确性有限。有家族史的妇女乳房（FHBC）最需要更好的风险评估，因为它们通常会接受相同的临床建议在FHBC范围内，潜在风险的目的地存在实质性异质性。整合在结合详细的FHBC数据，为增强现有风险评估提供了极大的机会方法。 MBD通常会随着年龄的增长而下降，但妇女之间的变化率谨慎，以及可能对乳腺癌的风险特别重要；我们已经证明了保持高处的妇女随着时间的流逝，MBD比MBD下降的女性更有可能被诊断出患有乳腺癌。通过合并MBD来改善风险预测模型的尝试取得了有限的成功，因为研究使用一次性MBD的度量，其中主要包括绝经后妇女，其中最大的变化在MBD中可能已经发生。我们建议研究MBD的个人内部变化10- 与FHBC的程度相关的乳腺癌的年度（AIM 1），并评估如何变化 MBD可以改善几种临床风险预测模型（AIM 2）和临床风险分层形成基础用于基于风险的监视和预防保健（AIM 3）。我们将通过建立美国来解决这些目标姐妹研究，一个前瞻性队列，由50,884名妇女有一个或多个被诊断出患有乳腺癌的姐妹 2003年至2009年在招生时亲自乳腺癌的人；对AT进行了积极的年度随访每个女人至少十年。使用嵌套的病例对照设计，我们将检索现有的乳房X线照片对于所有事件的乳腺癌病例≤60岁（迄今为止n = 1,242例）和对照匹配年龄和入学年度（病例识别时，每个病例中选择了2个对照）。我们将使用两项临床可用的定性措施对MBD进行全面评估临床实践，并评估允许衡量较小变化和的定量措施与乳房独立相关的MBD的不同成分癌症风险。我们团队在姐姐中领先的MBD研究和潜在可用数据方面的经验研究将对与乳腺癌风险有关的前瞻性MBD变化进行无与伦比的研究，可修改和遗传因素，以及如何使用此信息来增强患有 FHBC。这些结果对于基于个性化风险的监视和预防计划是必要的。