Feigelson Heather Spencer, Patel Alpa V, Teras Lauren R, Gansler Ted, Thun Michael J, Calle Eugenia E
Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Georgia 30329, USA.
Cancer. 2006 Jul 1;107(1):12-21. doi: 10.1002/cncr.21965.
Although the link between postmenopausal breast cancer and adiposity is well established, the association between weight gain and specific histopathologic characteristics of breast carcinoma has not been studied carefully.
Using 1200 incident invasive breast cancers among 44,161 postmenopausal women who were not taking hormone therapy in the American Cancer Society's Cancer Prevention Study II Nutrition Cohort, the authors computed age-adjusted rates and rate ratios (RR) for breast cancer by histology, stage, grade, and estrogen receptor (ER) and progesterone receptor (PR) status by categories of adult weight gain.
Age-adjusted rates of breast cancer were highest for women who reported the most weight gain, regardless of histologic type. For weight gain >60 pounds, compared with weight gain < or =20 pounds the RR for ductal carcinoma was 1.89 (95% confidence interval [95%CI], 1.53-2.34), and the RR for lobular carcinoma was 1.54 (95%CI. 1.01-2.33). Weight gain was associated with increased risk at every tumor stage and grade. The risk for regional or distant stage was elevated significantly in every category of weight gain and was 3 times higher among women who had the greatest weight gain (RR, 3.15; 95%CI, 2.21-4.48). Weight gain was associated with increased risk of ER-positive/PR-positive tumors (P for trend <.0001) but not ER-negative/PR-negative tumors (P for trend = .09). The results essentially remained unchanged when the analysis was restricted to women who had regular screening mammograms.
Excess adiposity is an important contributor to breast cancer risk among postmenopausal women, regardless of histologic type, and especially for tumors of advanced stage and high grade.
尽管绝经后乳腺癌与肥胖之间的联系已得到充分证实，但体重增加与乳腺癌特定组织病理学特征之间的关联尚未得到仔细研究。
在美国癌症协会癌症预防研究II营养队列中，对44161名未接受激素治疗的绝经后女性中的1200例浸润性乳腺癌患者，作者按成人体重增加类别计算了按组织学、分期、分级以及雌激素受体（ER）和孕激素受体（PR）状态分类的乳腺癌年龄调整发病率和发病率比（RR）。
无论组织学类型如何，报告体重增加最多的女性的年龄调整乳腺癌发病率最高。与体重增加≤20磅相比，体重增加>60磅时，导管癌的RR为1.89（95%置信区间[95%CI]，1.53 - 2.34），小叶癌的RR为1.54（95%CI，1.01 - 2.33）。体重增加与每个肿瘤分期和分级的风险增加相关。在每个体重增加类别中，区域或远处分期的风险均显著升高，体重增加最多的女性中该风险高出3倍（RR，3.15；95%CI，2.21 - 4.48）。体重增加与ER阳性/PR阳性肿瘤的风险增加相关（趋势P<.0001），但与ER阴性/PR阴性肿瘤无关（趋势P = 0.09）。当分析仅限于定期进行乳腺钼靶筛查的女性时，结果基本保持不变。
肥胖是绝经后女性患乳腺癌风险的重要因素，无论组织学类型如何，尤其是对于晚期和高级别肿瘤。
