Patel Alpa V, Press Michael F, Meeske Kathleen, Calle Eugenia E, Bernstein Leslie
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California 90033, USA.
Cancer. 2003 Nov 15;98(10):2161-9. doi: 10.1002/cncr.11768.
The incidence rates of breast carcinoma in situ (BCIS) have increased dramatically over the past two decades, primarily because of increased mammography screening. Ductal carcinoma in situ, which accounts for approximately 85% of BCIS and 10-20% of all breast carcinomas, is generally recognized as the final step in the progression to invasive disease. To the authors' knowledge, few studies have been conducted to date to evaluate BCIS risk factors. Because of its potential effects on circulating sex hormones, physical activity has been proposed as a modifiable risk factor for invasive breast carcinoma. However, the relation to BCIS risk is poorly understood.
The authors analyzed data from a population-based case-control study conducted in Los Angeles County. Personal interviews were conducted with 567 white and black women (age range, 35-64 years) who had been newly diagnosed with BCIS between March 1, 1995 and May 31, 1998 and with 1026 control subjects, of whom 616 were screened within 2 years of identification.
After excluding unscreened control subjects (n = 410) and adjusting for potential confounding factors, the risk of BCIS was approximately 35% lower among women with any exercise activity compared with inactive women, although no significant trend was observed. The association between exercise activity and the risk of BCIS was modified by a family history of breast carcinoma. No reduction in risk was observed among women reporting a first-degree family history of breast carcinoma (homogeneity of trends P value = 0.02).
The findings of the current study suggest that exercise activity may modify the risk of BCIS, particularly among women without a family history of breast carcinoma.
在过去二十年中，原位乳腺癌（BCIS）的发病率急剧上升，主要原因是乳房X线筛查的增加。导管原位癌约占BCIS的85%，占所有乳腺癌的10 - 20%，通常被认为是进展为浸润性疾病的最后一步。据作者所知，迄今为止很少有研究评估BCIS的危险因素。由于体育活动对循环性激素有潜在影响，它已被提出作为浸润性乳腺癌的一个可改变的危险因素。然而，其与BCIS风险的关系尚不清楚。
作者分析了在洛杉矶县进行的一项基于人群的病例对照研究的数据。对1995年3月1日至1998年5月31日期间新诊断为BCIS的567名白人和黑人女性（年龄范围35 - 64岁）以及1026名对照受试者进行了个人访谈，其中616名对照受试者在被识别后的2年内接受了筛查。
在排除未接受筛查的对照受试者（n = 410）并对潜在混杂因素进行调整后，与不运动的女性相比，有任何运动活动的女性患BCIS的风险大约低35%，尽管未观察到显著趋势。运动活动与BCIS风险之间的关联因乳腺癌家族史而有所改变。在报告有乳腺癌一级家族史的女性中未观察到风险降低（趋势同质性P值 = 0.02）。
本研究结果表明，运动活动可能会改变BCIS的风险，特别是在没有乳腺癌家族史的女性中。
