Althuis Michelle D, Brogan Donna D, Coates Ralph J, Daling Janet R, Gammon Marilie D, Malone Kathleen E, Schoenberg Janet B, Brinton Louise A
National Cancer Institute, Rockville, MD, USA.
Cancer Causes Control. 2003 Mar;14(2):151-60. doi: 10.1023/a:1023006000760.
To assess risk factors for breast cancer among very young compared to older premenopausal women.
Between 1990 and 1992 a population-based case-control study conducted in Atlanta, GA, Seattle/Puget Sound, WA, and central NJ interviewed 3307 premenopausal women aged 20-54 years. Logistic regression models estimated adjusted relative risks (RR) and 95% confidence intervals (CI) for each of three 10-year age groups.
Among the youngest age group (<35 years, n = 545), significant predictors of risk included African-American race (RR = 2.66: 95% CI 1.4-4.9) and recent use of oral contraceptives (RR = 2.26; 95% CI 1.4-3.6). Although these relationships were strongest for estrogen receptor-negative (ER-) tumors (RRs of 3.30 for race and 3.56 for recent oral contraceptive use), these associations were also apparent for young women with ER+ tumors. Delayed childbearing was a risk factor for ER+ tumors among the older premenopausal women (Ptrend < 0.01), but not for women <35 years in whom early childbearing was associated with an increased risk, reflecting a short-term increase in risk immediately following a birth. Family history of early-onset breast cancer was more strongly associated with risk among women <35 years (RR = 3.22) than those 45-54 years (RR = 1.51). Risk factors for premenopausal breast cancer not significantly modified by age at diagnosis included early age at menarche, low body mass index, and heavy alcohol consumption.
These findings suggest the possibility that women who develop breast cancers at very young ages may be etiologically as well as clinically distinct.
评估与年龄较大的绝经前女性相比，非常年轻的女性患乳腺癌的风险因素。
1990年至1992年间，在佐治亚州亚特兰大、华盛顿州西雅图/普吉特海湾和新泽西州中部开展了一项基于人群的病例对照研究，对3307名年龄在20 - 54岁的绝经前女性进行了访谈。逻辑回归模型估计了三个10岁年龄组中每组的调整相对风险（RR）和95%置信区间（CI）。
在最年轻的年龄组（<35岁，n = 545）中，风险的显著预测因素包括非裔美国人种族（RR = 2.66；95% CI 1.4 - 4.9）和近期使用口服避孕药（RR = 2.26；95% CI 1.4 - 3.6）。尽管这些关系在雌激素受体阴性（ER-）肿瘤中最为明显（种族的RR为3.30，近期口服避孕药使用的RR为3.56），但在患有ER+肿瘤的年轻女性中这些关联也很明显。晚育是年龄较大的绝经前女性中ER+肿瘤的一个风险因素（Ptrend < 0.01），但对于<35岁的女性来说并非如此，在这些女性中早育与风险增加相关，这反映出产后风险会立即出现短期增加。早发性乳腺癌家族史在<35岁的女性（RR = 3.22）中比在45 - 54岁的女性（RR = 1.51）中与风险的关联更强。绝经前乳腺癌的风险因素在诊断时的年龄方面没有显著改变，包括初潮年龄早、体重指数低和大量饮酒。
这些发现表明，在非常年轻的年龄患乳腺癌的女性在病因学和临床方面可能都有所不同。
