我们探讨了筛查检测出的患有小（<15毫米）和大（≥15毫米）浸润性乳腺癌的女性的乳房X线照相特征与乳腺癌死亡风险之间的关联。我们纳入了17,614名因以下原因被诊断患有浸润性乳腺癌的女性的数据：参与挪威乳腺癌筛查，1996-2020 年。乳房X线照相特征（肿块、针状肿块、结构扭曲、不对称密度、钙化密度和单独钙化密度）、肿瘤直径和死亡原因的数据来自挪威癌症登记处。使用 Cox 回归以针状肿块作为参考，根据年龄、肿瘤直径和淋巴结状态进行调整，通过乳房 X 线照相特征来估计乳腺癌死亡的风险比 (HR) 和 95% 置信区间 (CI)。所有分析均按肿瘤直径（小与大）进行二分。10,160 名患有小肿瘤的女性的平均诊断年龄为 60.8 岁（标准差，SD=5.8），7454 名患有大肿瘤的女性的平均诊断年龄为 60.0（SD=5.8）。乳腺癌死亡人数分别为 299 人和 634 人。小肿瘤女性从诊断到死亡的平均时间为 8.7 (SD=5.0) 年，大肿瘤女性为 7.2 (4.6) 年。使用针状肿块作为参考，小肿瘤女性乳腺癌死亡的校正 HR（仅钙化）为 2.48（95% CI 1.67-3.68），而大肿瘤女性乳腺癌密度的 HR 为 1.30（95% CI 1.02-1.66）小屏幕检测到的表现为钙化的浸润性癌症和大屏幕检测到的表现为密度伴钙化的癌症与乳腺癌死亡的最高风险相关。小肿瘤（<15 mm）表现为单独钙化，大肿瘤（≥ 15 mm）表现为钙化密度，与 1996 年至 2020 年诊断出的筛查检测出的浸润性乳腺癌女性中乳腺癌死亡的最高风险相关。• 对 1996 年至 2020 年诊断出筛查出的浸润性乳腺癌的女性进行了分析。 • 小屏幕检测到的仅表现为钙化的癌症导致乳腺癌死亡的风险最高。 • 大屏幕检测到的癌症表现为密度伴钙化，导致乳腺癌死亡的风险最高。© 2023。作者。

We explored associations between mammographic features and risk of breast cancer death among women with small (<15 mm) and large (≥15 mm) invasive screen-detected breast cancer.We included data from 17,614 women diagnosed with invasive breast cancer as a result of participation in BreastScreen Norway, 1996-2020. Data on mammographic features (mass, spiculated mass, architectural distortion, asymmetric density, density with calcification and calcification alone), tumour diameter and cause of death was obtained from the Cancer Registry of Norway. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for breast cancer death by mammographic features using spiculated mass as reference, adjusting for age, tumour diameter and lymph node status. All analyses were dichotomised by tumour diameter (small versus large).Mean age at diagnosis was 60.8 (standard deviation, SD=5.8) for 10,160 women with small tumours and 60.0 (SD=5.8) years for 7454 women with large tumours. The number of breast cancer deaths was 299 and 634, respectively. Mean time from diagnosis to death was 8.7 (SD=5.0) years for women with small tumours and 7.2 (4.6) years for women with large tumours. Using spiculated mass as reference, adjusted HR for breast cancer death among women with small tumours was 2.48 (95% CI 1.67-3.68) for calcification alone, while HR for women with large tumours was 1.30 (95% CI 1.02-1.66) for density with calcification.Small screen-detected invasive cancers presenting as calcification and large screen-detected cancers presenting as density with calcification were associated with the highest risk of breast cancer death.Small tumours (<15 mm) presented as calcification alone and large tumours (≥ 15 mm) presented as density with calcification were associated with the highest risk of breast cancer death among women with screen-detected invasive breast cancer diagnosed 1996-2020.• Women diagnosed with invasive screen-detected breast cancer 1996-2020 were analysed. • Small screen-detected cancers presenting as calcification alone resulted in the highest risk of breast cancer death. • Large screen-detected cancers presenting as density with calcification resulted in the highest risk of breast cancer death.© 2023. The Author(s).