Ramakrishnan Rathi, Gann Peter H, Wiley Elizabeth L, Khurana Kamal K, Khan Seema A
Department of Surgery, The Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Breast Cancer Res Treat. 2004 Aug;86(3):259-68. doi: 10.1023/B:BREA.0000036899.97114.b3.
Rodent studies suggest a relationship between lobular maturation and breast cancer risk. Human data are sparse, and were developed using whole mounts of mastectomy or mammoplasty samples, without consideration of menstrual phase in premenopausal women. We studied normal breast lobules in relation to cancer risk in 284 women, using surgical biopsy material (mean two sections and 43.2 lobular structures per subject): 167 were premenopausal; 89 with breast cancer (cases) and 78 undergoing benign breast biopsy (controls). Of 117 postmenopausal women, 67 were cases and 50 were controls. Normal lobular type was classified based on size, and was designated predominant if it constituted 60% or more of the total lobules classified. The control group showed 66% type I, 34% type II and 1% type III lobules while cases showed 69% type I, 31% type II and 7% type III structures. Predominant lobule type showed no association with cancer (p = 0.9). Postmenopausal women had a substantially higher proportion of type I lobules compared to premenopausal women, irrespective of the parity or cancer status (p < 0.001). Lobule type was not associated with menstrual phase classified by dates; however, when menstrual phase was classified using breast morphological characteristics, type I lobules were more abundant in follicular phase and type II in the luteal phase (p < 0.001). In conclusion, we did not observe a relationship between lobular architecture and breast cancer susceptibility when using smaller breast samples usually available in epidemiological studies, but these data highlight the need for menstrual phase stratification in future investigations.
啮齿动物研究表明小叶成熟与乳腺癌风险之间存在关联。人类数据稀少，且是使用乳房切除术或乳房成形术样本的整体标本得出的，未考虑绝经前女性的月经周期。我们使用手术活检材料（每位受试者平均两片切片和43.2个小叶结构）研究了284名女性正常乳腺小叶与癌症风险的关系：167名是绝经前女性；89名患有乳腺癌（病例组），78名接受良性乳腺活检（对照组）。在117名绝经后女性中，67名是病例组，50名是对照组。正常小叶类型根据大小分类，如果其占分类的小叶总数的60%或更多，则被指定为主导类型。对照组显示66%为I型小叶，34%为II型小叶，1%为III型小叶，而病例组显示69%为I型小叶，31%为II型小叶，7%为III型结构。主导小叶类型与癌症无关联（p = 0.9）。绝经后女性与绝经前女性相比，I型小叶的比例显著更高，无论其生育情况或癌症状态如何（p < 0.001）。小叶类型与按日期分类的月经周期无关；然而，当使用乳房形态特征对月经周期进行分类时，I型小叶在卵泡期更为丰富，II型小叶在黄体期更为丰富（p < 0.001）。总之，在使用流行病学研究中通常可获得的较小乳房样本时，我们未观察到小叶结构与乳腺癌易感性之间的关系，但这些数据凸显了未来研究中进行月经周期分层的必要性。
