Poisson regression analysis of influencing factors of minimal breast cancer in female retired cadres in Shanghai

  Objective  To analyze the prevalence status, influencing factors and diagnostic efficacy of corresponding detection methods of minimal breast cancer among female retired cadres in Shanghai, so as to provide scientific basis for follow-up diagnosis and prevention.

  Methods  The medical records of 12 867 female retired cadres in Shanghai who underwent regular physical examination from December 2016 to December 2019 were analyzed retrospectively. These subjects were examined by breast physical examination and routine ultrasound, and the cases with suspected minimal breast cancer were examined by automated breast volume scanning(ABVS)combined with mammography(MG), and diagnosed by pathological method; Poisson regression was used to analyze the influencing factors of breast cancer. The consistency of the diagnostic results of each method was tested, and its diagnostic efficiency was analyzed.

  Results  Totally 2 924 cases were detected as suspected minimal breast cancer in 12 867 female retired cadres, and 10 cases were diagnosed as minimal breast cancer by pathological methods. The detection rates of minimal breast cancer in 2017, 2018 and 2019 were 69.99/10⁵, 74.74/10⁵ and 87.59/10⁵, respectively. The total physical examination rate was 77.72/10⁵. Poisson regression analysis showed that age ≥ 50 years old, overweight and obesity, genetic history of breast related diseases, history of X-ray irradiation, occupational stress, failure to breastfeed, menopause, history of previous hormone use, history of thyroid disease, unmarried or widowed, and history of hysteromyoma were risk factors for minimal breast cancer(OR = 1.137 - 2.296, P < 0.05). The consistency Kappa values of three methods (ABVS, MG and ABVS + MG combination)and confirmed cases were 0.889, 0.823 and 1.000, respectively (P < 0.05);the sensitivity was > 0.700, the specificity was > 0.999, and the accuracy was > 0.999. Among 10 patients with minimal breast cancer, 8 cases were diagnosed by ABVS, and 2 cases were misdiagnosed as benign lesions; 7 cases were diagnosed by MG, and 3 cases were misdiagnosed as benign lesions.

  Conclusions  There is a high prevalence of minimal breast cancer among female retired cadres in Shanghai, which is affected by many high-risk factors. ABVS combined with MG technology is recommended for routine screening, so as to provide reference for early diagnosis and treatment of breast cancer.