Rawal R, Lorenzo Bermejo J, Hemminki K
German Cancer Research Center, Division of Molecular Genetic Epidemiology, Im Neuenheimer Feld 580, Heidelberg D-69120, Germany.
Br J Cancer. 2005 Jan 17;92(1):162-6. doi: 10.1038/sj.bjc.6602250.
Sweden was the first country to establish a nationwide breast cancer screening service. We used the Swedish Family-Cancer Database to evaluate the risk of invasive carcinoma after in situ carcinoma of the breast. Risk estimates for contralateral and ipsilateral invasive malignancies following age and histology specific in situ breast carcinomas were calculated using Poisson's regression analysis. The agreement between concordant and discordant morphologies of invasive and in situ breast cancer was measured using the kappa statistic. Women with in situ breast cancer showed a relative risk of 2.03 for contralateral and 3.94 for ipsilateral invasive breast cancer. The risk was higher for in situ carcinomas diagnosed before the age of 50 years and after lobular in situ breast cancers. A comparison of the risks during the past decades suggested that the risk of ipsilateral breast cancer has increased in Sweden but that of contralateral breast cancer has remained unchanged. In situ and the subsequent invasive breast cancers did not seem to share their morphologies.
瑞典是首个建立全国性乳腺癌筛查服务的国家。我们利用瑞典家庭癌症数据库评估乳腺原位癌后发生浸润性癌的风险。采用泊松回归分析计算年龄和组织学特异性乳腺原位癌后对侧和同侧浸润性恶性肿瘤的风险估计值。使用kappa统计量衡量浸润性和原位乳腺癌一致和不一致形态之间的一致性。乳腺原位癌女性对侧浸润性乳腺癌的相对风险为2.03，同侧为3.94。50岁之前诊断出的原位癌以及小叶原位乳腺癌后发生浸润性癌的风险更高。过去几十年风险比较表明，瑞典同侧乳腺癌风险增加，但对侧乳腺癌风险保持不变。原位癌及随后的浸润性乳腺癌似乎没有相同的形态。
