Introduction: An inverse association between high mammographic breast density (MBD) and pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) for early breast cancer (EBC) has been reported. However, the relationship of MBD to relapse-free (RFS) and breast cancer-specific survival (BCSS) is unexplored. This study aims to validate the relationship between MBD and NAC pCR in EBC and to assess correlations with RFS and BCSS. Materials & Methods: MBD was measured on contralateral mammograms in 127 women before NAC using Cumulus software. The percent dense area was correlated with patient and tumour characteristics, pCR, RFS and BCSS. Results: Mean MBD was higher in relapsing patients (p= 0.041) but did not vary by pCR or BC-deaths. As a dichotomous variable, no difference was seen between high and low MBD cohorts for pCR (17.5 vs. 25.0%,p= 0.15), BC relapse (38 vs. 30%,p= 0.15) or BC death (32 vs. 25%,p= 0.20). A planned analysis by body mass index (BMI) demonstrated high MBD associated with lower pCR (0% vs. 28.1%,p= 0.036) and trends for higher relapse (56% vs. 28%,p= 0.063) and BC deaths (56 vs. 28%, (p= 0.071)) in obese patients. No relationship was observed in non-obese patients. Conclusions: Obesity and high MBD may interact to cause chemoresistance. Further research in these patients is warranted.
引言：已有研究报道，早期乳腺癌新辅助化疗后，较高的乳腺钼靶密度与病理完全缓解呈负相关。然而，乳腺密度与无复发生存期及乳腺癌特异性生存率的关系尚未明确。本研究旨在验证早期乳腺癌中乳腺密度与新辅助化疗病理完全缓解的关系，并评估其与无复发生存期及乳腺癌特异性生存率的相关性。材料与方法：使用Cumulus软件测量127例女性患者新辅助化疗前对侧乳腺钼靶的密度值。将密度百分比与患者及肿瘤特征、病理完全缓解、无复发生存期及乳腺癌特异性生存率进行相关性分析。结果：复发患者的平均乳腺密度较高（p=0.041），但未发现其与病理完全缓解或乳腺癌死亡存在差异。作为二分类变量，高密度组与低密度组在病理完全缓解率（17.5%对25.0%，p=0.15）、乳腺癌复发率（38%对30%，p=0.15）及乳腺癌死亡率（32%对25%，p=0.20）方面均无统计学差异。按体重指数进行的预设分析显示，肥胖患者中高乳腺密度与较低的病理完全缓解率（0%对28.1%，p=0.036）相关，并呈现较高复发率（56%对28%，p=0.063）和乳腺癌死亡率（56%对28%，p=0.071）的趋势，而非肥胖患者中未观察到相关性。结论：肥胖与高乳腺密度可能共同导致化疗耐药，对此类患者需开展进一步研究。
肿瘤(癌症)患者之家