Kinnunen Tarja I, Luoto Riitta, Gissler Mika, Hemminki Elina, Hilakivi-Clarke Leena
Lombardi Cancer Center and Department of Oncology, Georgetown University, 3970 Reservoir Rd, NW, Washington, DC 20057, USA.
BMC Womens Health. 2004 Oct 21;4(1):7. doi: 10.1186/1472-6874-4-7.
Elevated pregnancy estrogen levels are associated with increased risk of developing breast cancer in mothers. We studied whether pregnancy weight gain that has been linked to high circulating estrogen levels, affects a mother's breast cancer risk. METHODS: Our cohort consisted of women who were pregnant between 1954-1963 in Helsinki, Finland, 2,089 of which were eligible for the study. Pregnancy data were collected from patient records of maternity centers. 123 subsequent breast cancer cases were identified through a record linkage to the Finnish Cancer Registry, and the mean age at diagnosis was 56 years (range 35 - 74). A sample of 979 women (123 cases, 856 controls) from the cohort was linked to the Hospital Inpatient Registry to obtain information on the women's stay in hospitals. RESULTS: Mothers in the upper tertile of pregnancy weight gain (>15 kg) had a 1.62-fold (95% CI 1.03-2.53) higher breast cancer risk than mothers who gained the recommended amount (the middle tertile, mean: 12.9 kg, range 11-15 kg), after adjusting for mother's age at menarche, age at first birth, age at index pregnancy, parity at the index birth, and body mass index (BMI) before the index pregnancy. In a separate nested case-control study (n = 65 cases and 431 controls), adjustment for BMI at the time of breast cancer diagnosis did not modify the findings. CONCLUSIONS: Our study suggests that high pregnancy weight gain increases later breast cancer risk, independently from body weight at the time of diagnosis.
孕期雌激素水平升高与母亲患乳腺癌风险增加有关。我们研究了与高循环雌激素水平相关的孕期体重增加是否会影响母亲患乳腺癌的风险。
我们的队列由1954年至1963年期间在芬兰赫尔辛基怀孕的女性组成,其中2089名符合研究条件。孕期数据从产科中心的患者记录中收集。通过与芬兰癌症登记处的记录链接识别出123例后续乳腺癌病例,诊断时的平均年龄为56岁(范围35 - 74岁)。该队列中的979名女性样本(123例病例,856例对照)与医院住院登记处相链接,以获取这些女性的住院信息。
在调整了母亲初潮年龄、首次生育年龄、本次怀孕年龄、本次分娩时的产次以及本次怀孕前的体重指数(BMI)后,孕期体重增加处于上三分位数(>15 kg)的母亲患乳腺癌的风险比体重增加达到推荐量的母亲(中间三分位数,平均:12.9 kg,范围11 - 15 kg)高1.62倍(95%置信区间1.03 - 2.53)。在一项单独的巢式病例对照研究(n = 65例病例和431例对照)中,对乳腺癌诊断时的BMI进行调整并未改变研究结果。
我们的研究表明,孕期体重过度增加会增加日后患乳腺癌的风险,且独立于诊断时的体重。