乳腺良恶性病变及正常女性乳腺密度类型分析

Analysis on type of mammographic density among women with malignant, benign breast lesions and normal breasts

目的比较乳腺恶性、良性病变及正常女性的乳腺密度类型,分析各年龄阶段不同类型乳腺密度的恶性和良性病变检出率。方法收集首次接受全数字化乳腺摄影检查的4 241例女性患者的临床资料。根据乳腺腺体成分所占百分比将乳腺密度分为4型,即〉75%、51%~75%、25%~50%和〈25%。乳腺影像存在异常时进一步行病理学检测以确定病变性质。结果乳腺密度随年龄的增加逐渐下降;乳腺恶性病变、良性病变及正常女性之间的乳腺密度类型构成比差异有统计学意义（P〈0.05）;年龄≥40岁恶性病变检出率随乳腺密度减低逐渐升高（P〈0.01）,年龄40~60岁良性病变检出率随乳腺密度减低逐渐降低（P=0.037）。结论乳腺密度作为一项影像检查指标评估乳腺病变风险具有重要价值,不同年龄女性人群中乳腺密度对乳腺良性和恶性病变的风险尺度和效应不一致。

Objective To compare the types ofmammographic density among women with malignant, be- nign breast lesions and normal breasts, and to analyze the detection rate of women with malignant and benign breast lesions by age and type of mammographic density. Methods The clinical data of 4 241 women that accepted digitized film images with computerized techniques examination for the first time were collected. Four types of mammographic density were determined according to percentage of fibroglandular tissue, 〉75%, 51%~75%, 25%-50% and 〈25%. A fur- ther pathological detection was performed to determine the lesions type when there was abnormal breast imaging. Results The descending of mammographic density was associated with age, and statistically differences were found in the distribution of mammographic density type among women with malignant, benign breast lesions and normal breasts （P〈0.05）. The increasing of positive rate of women with malignant breast lesions was associated with the descending of mammographic density at the age ≥40 （P〈0.05）, and the decline of positive rate of women with benign breast lesions was associated with descending of mammographic density at the age of 40~60 （P=0.037）. Conclusion Mammographic density as an imaging index is important for assessing the risk of breast lesions. Mammo- graphic density exerts discreoant risk scale and effect on women with malignant and benign breast lesions at different age.