Abstract 5741: Change in mammographic density with estrogen and progestin therapy: A measure of breast cancer risk in the Women's Health Initiative
Notice bibliographique
Résumé
Abstract Background: In 2002 the Women's Health Initiative (WHI) reported an increased rate of breast cancer with estrogen and progestin therapy (EPT). Percent mammographic density (MD) is one of the strongest predictors of breast cancer risk and may be a useful intermediate marker of change in breast cancer risk. We conducted a nested case-control study within the WHI to determine if change in MD with EPT could explain the increased breast cancer risk among these women. Methods: We obtained and digitized the baseline (prior to randomization) and the 1 year post randomization follow-up mammograms from the contralateral breast of 97 women who developed invasive breast cancer after the date of their follow-up mammogram in the EPT and 77 in the placebo arms of the WHI as well as a mammogram from a random side from 733 healthy women (controls) matched to the cases on clinical center, age, and treatment arm (378 and 355 respectively). Four experienced readers blinded to treatment and outcome assessed MD, the proportion of the breast area appearing dense on the mammogram, using two different validated computer-assisted techniques (Cumulus and Madena). The four readers’ results were highly correlated (correlation coefficients > 0.92) and averaged in this study. The risk associated with both baseline MD and change in MD was evaluated. Using logistic regression models controlling for confounders and baseline MD, we determined the degree to which change in MD after initiation of EPT predicted breast cancer risk in this group and potentially explained the breast cancer risk associated with EPT. Results: Of the women in the placebo arm approximately half (57%) had a decline in MD and 47% had a modest increase in MD. In contrast, 84% of women in the EPT arm had increased MD while only 16% had a decrease. In the EPT arm both baseline and change in MD were significantly associated with breast cancer risk (baseline MD OR= 1.03; 95% CI 1.01-1.05 per 1% in MD and change in MD OR= 1.03; 95% CI 1.01-1.06 per 1% increase in MD). Among the 20% of women with the greatest increase in MD (>19.3 %) in the EPT arm of the study, breast cancer risk increased 3.6-fold (95% CI 1.52-8.56) compared to the 20% with the lowest increase (< 0.6 %) or decrease. The OR within this sub-study for the effect of EPT on breast cancer risk compared to placebo was 1.28 (95% CI 0.90-1.82) similar to that of the entire WHI where the HR for EPT was 1.24 (95% CI: 1.01-1.54). After adjusting for change in MD, EPT was no longer associated with breast cancer risk within this nested study population (adjusted OR=0.99; 95% CI: 0.66-1.51). Conclusions: In this nested study within the WHI randomized trial of the effects of EPT, the associated change in MD was a significant predictor of breast cancer risk and statistically accounted for the increased breast cancer risk associated with EPT. Thus change in MD may be a useful intermediate marker of increased breast cancer risk with use of EPT. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5741.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».