Baer Heather J, Schnitt Stuart J, Connolly James L, Byrne Celia, Willett Walter C, Rosner Bernard, Colditz Graham A
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
Cancer Epidemiol Biomarkers Prev. 2005 Dec;14(12):2889-97. doi: 10.1158/1055-9965.EPI-05-0525.
Proliferative benign breast disease is a marker of increased breast cancer risk, yet little is known about its etiology. Most studies of benign breast disease have focused only on risk factors in adulthood, despite growing evidence that factors in early life influence breast cancer risk. We explored the relations of several early life factors with incidence of proliferative benign breast disease among 71,896 premenopausal women in the Nurses' Health Study II who recalled their body fatness at young ages, physical activity in adolescence, birthweight, and history of being breastfed. Between 1991 and 1997, 901 of these women were identified as having proliferative benign breast disease from a centralized pathology review. Relative risks (RR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazards models. Greater childhood body fatness (ages 5-10) was associated with decreased risk of proliferative benign breast disease; the multivariate RR (95% CI) for the most overweight compared with the most lean was 0.61 (0.44-0.86; P(trend) < 0.0001) and remained significant after adjustment for current body mass index. Body mass index at age 18 was also inversely associated with incidence of proliferative benign breast disease, with a multivariate RR (95% CI) of 0.67 (0.52-0.88) for those who were > or =25 kg/m(2) compared with those who were <19 kg/m(2) (P(trend) = 0.001). There were no clear associations for physical activity in adolescence, birthweight, or being breastfed. These results indicate that premenopausal women who were heavier at young ages have lower incidence of proliferative benign breast disease, consistent with previous findings for breast cancer.
增生性良性乳腺疾病是乳腺癌风险增加的一个标志,但对其病因知之甚少。大多数关于良性乳腺疾病的研究仅关注成年期的风险因素,尽管越来越多的证据表明早年的因素会影响乳腺癌风险。我们在护士健康研究II的71896名绝经前女性中探讨了几种早年因素与增生性良性乳腺疾病发病率之间的关系,这些女性回忆了她们年轻时的体脂情况、青春期的身体活动、出生体重以及母乳喂养史。在1991年至1997年期间,通过集中病理审查,这些女性中有901人被确定患有增生性良性乳腺疾病。相对风险(RR)和95%置信区间(95%CI)由Cox比例风险模型估计。儿童期(5 - 10岁)体脂越高,增生性良性乳腺疾病的风险越低;与最瘦的人相比,最超重者的多变量RR(95%CI)为0.61(0.44 - 0.86;P趋势<0.0001),在调整当前体重指数后仍具有显著性。18岁时的体重指数也与增生性良性乳腺疾病的发病率呈负相关,与体重指数<19kg/m²的人相比,体重指数≥25kg/m²的人的多变量RR(95%CI)为0.67(0.52 - 0.88)(P趋势=0.001)。青春期的身体活动、出生体重或母乳喂养没有明显的关联。这些结果表明,年轻时体重较重的绝经前女性增生性良性乳腺疾病的发病率较低,这与先前关于乳腺癌的研究结果一致。