Mammographic density and breast cancer screening

Abstract

Mammographic density, which is determined by the relative amounts of fibroglandular tissue and fat in the breast, varies between women. Mammographic density is associated with a range of factors, including age and body mass index. The description of mammographic density has been transformed by the digitalization of mammography, which has allowed automation of the assessment of mammographic density, rather than using visual inspection by a radiologist. High mammographic density is important because it is associated with reduced sensitivity for the detection of breast cancer at the time of mammographic screening. High mammographic density is also associated with an elevated risk of developing breast cancer. Mammographic density appears to be on the causal pathway for some breast cancer risk factors, but not others. Mammographic density needs to be considered in the context of a woman’s background risk of breast cancer. There is intense debate about the use of supplementary imaging for women with high mammographic density. Should supplementary imaging be used in women with high mammographic density and a clear mammogram? If so, what modalities of imaging should be used and in which women? Trials are underway to address the risks and benefits of supplementary imaging.

摘要

乳腺钼靶密度是由乳腺纤维组织和脂肪的相对数量决定的, 不同女性的乳腺密度不同。乳腺钼靶密度与一系列因素相关, 包括年龄和BMI。乳腺钼靶密度已进行了数字化转换, 从而实现了对乳腺钼靶密度进行了自动评估, 无需放射科医生的主观评估。高密度乳腺钼靶很重要, 因为它与乳腺钼靶筛查乳腺癌的敏感性降低相关。高密度乳腺钼靶检查也会增加乳腺癌的风险。乳腺钼靶密度似乎是一些乳腺癌危险因素的因果途径, 而不是其他。乳腺钼靶的密度需要考虑女性乳腺癌风险的背景。对于乳腺钼靶密度高的女性应用辅助成像存在激烈的争论。乳腺钼靶密度高且乳腺钼靶成像清晰的女性是否应当应用辅助成像？如果是这样, 应该在哪些女性中应用哪种成像方式？针对辅助成像的风险和益处的实验正在进行中。

Keywords:

• Mammographic screening
• mammographic density
• supplementary screening

Potential conflict of interest

The author reports no potential conflict of interest.

Source of funding

Nil.