Hankinson Susan E
Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA.
Breast Dis. 2005;24:3-15. doi: 10.3233/bd-2006-24102.
Multiple lines of evidence support a central role of hormones in the etiology of breast cancer. In epidemiologic studies, considerable effort has focused on delineating the role of endogenous hormones in risk of breast cancer among postmenopausal women. Recently, substantial additional data has accrued from prospective studies where endogenous hormones are measured in study subjects prior to disease diagnosis. In this review, the epidemiologic evidence linking sex steroids, prolactin and insulin-like growth factors (IGF) with subsequent risk of breast cancer in postmenopausal women is summarized and evaluated. Overall, a strong positive association between breast cancer risk and circulating levels of both estrogens and androgens has now been well confirmed; women with hormone levels in the top 20% of the distribution (versus bottom 20% have a 2- to 3-fold higher risk of breast cancer. Accumulating data also indicate a significant positive association with prolactin levels, although additional confirmation is needed. In contrast, no important link has been found between circulating levels of IGF-I (and its binding protein, IGFBP-3) and breast cancer risk in postmenopausal women.
多条证据支持激素在乳腺癌病因学中起核心作用。在流行病学研究中，大量精力集中于阐明内源性激素在绝经后女性患乳腺癌风险中的作用。最近，前瞻性研究积累了大量额外数据，这些研究在疾病诊断前对研究对象测量内源性激素。在本综述中，总结并评估了将性类固醇、催乳素和胰岛素样生长因子（IGF）与绝经后女性后续患乳腺癌风险联系起来的流行病学证据。总体而言，乳腺癌风险与雌激素和雄激素循环水平之间的强正相关现已得到充分证实；激素水平处于分布前20%的女性（相对于后20%）患乳腺癌的风险高2至3倍。越来越多的数据也表明与催乳素水平存在显著正相关，不过还需要更多证实。相比之下，未发现绝经后女性中IGF-I（及其结合蛋白IGFBP-3）的循环水平与乳腺癌风险之间存在重要联系。
