Association Between Ovarian And Breast Masses Among Chinese Women In Chongqing Based On Ultrasonography Screening

Background and purpose: Breast cancer is the most common malignancy among women and ovarian cancer is known as the first most lethal gynecologic malignancy.Since BRCA1 and BRCA2 were discovered in the 1990 s,these two female malignancies have been naturally linked together.There also have been a few studies about breast cancer risk in women with benign ovarian tumors,whereas found inconsistent results.Beast masses and ovarian masses are the major indicator of breast cancer and ovarian cancer in ultrasonic findings.Currently,a study evaluating the risk of breast masses or ovarian lesions among general population with ovarian lesions or breast masses is missing.Based on the above,the aim of this study is to explore the association between ovarian and breast masses and their prevalence in the general population in Chongqing(China)with a large sample size of health examination data.Methods:Consecutive women examinees who took health checkups between January 2015 and July 2018 and completed both breast and gynecological ultrasound scans during one health examination in The Quality Control Center of Health Examination in Chongqing(China)were included.Prevalence of breast and ovarian tumors was addressed.Logistic regressions were applied to assess the association between breast and ovarian lesions.Results:1.Among participants,8481(17.7%)had breast masses(BM),and2994(6.2%)had ovarian masses(OM).The prevalence of BM was 21.6%in women with OM,and 17.4% in those without OM.The prevalence of OM was 7.6% in women with BM,and 5.9% in those without BM.The prevalence of BM assigned into BI-RADS 2/3/≥4A among women with OM were 26.0%,11.0%,2.5% and the prevalence of BI-RADS 2/3/≥4A among women without OM were 21.8%,9.3%,2.0%,respectively.2.Age-specific prevalence of BM and OM showed the same peak at the age of 45-49 years,with a prevalence of 26.1%(95%CI: 25.1%-27.2%)for BM and 9.3%(95%CI: 8.6%-10.0%)for OM.A significant increase of BM prevalence during 18-49 years was followed by a drop during 50-79 years,and after 80 years of age,the BM prevalence increased slightly.In terms of OM,the prevalence increased from 18 to 49 years,then decreased from 50 to 69 years and after 70 years of age,it showed a gentle upward trend.3.After adjusting for age,height and BMI,BM was significantly associated with the risk of OM.Women with OM had a 1.139-fold risk(95%CI: 1.040-1.249,p=0.005)of having BM compared to those without OM.Similarly,women with BM increased risk of having OM compared to those without BM.The occurrence of OM increased the risk of BM assigned into BI-RADS category 2 and BI-RADS category 3 compared with those without OM(BI-RADS 2 OR=1.155,95%CI: 1.058-1.262,p=0.001;BI-RADS 3 OR= 1.132,95% CI: 1.001-1.280,p= 0.049)and the risk of OM was noticed in women with BM of BI-RADS category 2 and BI-RADS category 3(BI-RADS 2 OR = 1.156,95%CI:1.058-1.263,p= 0.001;BI-RADS 3 OR = 1.131,95%CI:1.000-1.280,p = 0.050).4.Subgroup analyses of menopausal status showed,in premenopausal women,the occurrence of OM was involved with BM(adjusted OR=1.163,95%CI: 1.033-1.308,p=0.012),but this correlation were no statistical significant in perimenopausal women(adjusted OR=1.128,95%CI:0.967-1.315,p=0.126)or postmenopausal women(adjusted OR=0.836,95%CI:0.507-1.378,p=0.481).In the BMI subgroup,the strongest association between OM and prevalence of BM appeared in underweight subgroup(adjusted OR=1.433,95% CI: 1.048-1.960,p=0.024).Besides,the association between OM and BM in normal weight women was still significant(adjusted OR=1.130,95%CI:1.018-1.253,p=0.021),but were no statistical significant in overweight(adjusted OR=1.043,95% CI: 0.800-1.359,p=0.758)or obese women(adjusted OR=0.971,95% CI: 0.381-2.471,p=0.951).5.The adjusted correlation between BM and OM was showed in normal weight women before menopause(adjusted OR=1.157,95%CI:1.014-1.321,p=0.031).Associations between OM and prevalence of BM in underweight,overweight,obese women before menopause were no statistical significant(underweight adjusted OR= 1.377,95%CI:0.972-1.951,p=0.072;overweight adjusted OR= 0.990,95%CI:0.656-1.492,p=0.960;obese adjusted OR=0.779,95%CI:0.161-3.773,p=0.757).There were no association between BM and the OM in perimenopausal or postmenopausal women,regardless of levels of BMI.Conclusions:The prevalence of BM and OM and their association in general population were demonstrated in our study,and we concluded that a high prevalence of ultrasound-revealed breast and ovarian tumors were found in Chinese women,and there was a positive correlation between OM and BM risk and vice versa,especially for premenopausal women,and women with lower BMI(underweight or normal weight).