年龄相关的小叶退化与乳腺癌风险

Age-related lobular involution and risk of breast cancer.

作者信息

Milanese Tia R, Hartmann Lynn C, Sellers Thomas A, Frost Marlene H, Vierkant Robert A, Maloney Shaun D, Pankratz V Shane, Degnim Amy C, Vachon Celine M, Reynolds Carol A, Thompson Romayne A, Melton L Joseph, Goode Ellen L, Visscher Daniel W

机构信息

Mayo Medical School, Rochester, MN 55905, USA.

出版信息

J Natl Cancer Inst. 2006 Nov 15;98(22):1600-7. doi: 10.1093/jnci/djj439.

DOI:10.1093/jnci/djj439

PMID:17105983

Abstract

BACKGROUND

As women age, the lobules in their breasts undergo involution or regression. We investigated whether lobular involution in women with benign breast disease was associated with subsequent breast cancer risk.

METHODS

We examined biopsy specimens of 8736 women in the Mayo Benign Breast Disease Cohort from whom biopsy samples were taken between January 1, 1967, and December 31, 1991. Median follow-up for breast cancer outcomes was 17 years. We classified lobular involution in the background breast tissue as none (0% involuted lobules), partial (1%-74%), or complete (> or = 75%). Subsequent breast cancer events and data on other risk factors were obtained from medical records and follow-up questionnaires. To estimate relative risks (RRs), standardized incidence ratios were calculated by use of incidence rates from the Iowa Surveillance, Epidemiology, and End Results (SEER) Registry. All statistical tests were two-sided.

RESULTS

Distribution of extent of involution was none among 1627 (18.6%) women, partial among 5197 (59.5%), and complete among 1912 (21.9%). Increased involution was positively associated with increased age and inversely associated with parity (both P<.001). The relative risk for the entire cohort of 8736 women, compared with the Iowa SEER population, was 1.40 (95% CI = 1.30 to 1.51). Risk of breast cancer was associated with the extent of involution (for no involution, RR [i.e., observed versus expected] = 1.88, 95% confidence interval [CI] = 1.59 to 2.21; for partial involution, RR = 1.47, 95% CI = 1.33 to 1.61; and for complete involution, RR = 0.91, 95% CI = 0.75 to 1.10; test for heterogeneity P<.001). Lobular involution modified risk in all subsets (e.g., among women with atypia, for no involution, RR = 7.79, 95% CI = 3.56 to 14.81; for partial involution, RR = 4.06, 95% CI = 3.03 to 5.33; and for complete involution, RR = 1.49, 95% CI = 0.41 to 3.82; P = .003).

CONCLUSIONS

In this large cohort of women with benign breast disease, lobular involution was associated with reduced risk of breast cancer. Aberrant involution may be a biologically important phenomenon in breast cancer biology.

摘要

背景

随着女性年龄增长，其乳房小叶会发生退化或萎缩。我们调查了患有良性乳腺疾病的女性的小叶退化是否与随后患乳腺癌的风险相关。

方法

我们检查了梅奥良性乳腺疾病队列中8736名女性的活检标本，这些标本于1967年1月1日至1991年12月31日期间采集。乳腺癌结局的中位随访时间为17年。我们将背景乳腺组织中的小叶退化分类为无（0%退化小叶）、部分（1% - 74%）或完全（≥75%）。随后的乳腺癌事件以及其他风险因素的数据来自医疗记录和随访问卷。为了估计相对风险（RRs），使用爱荷华州监测、流行病学和最终结果（SEER）登记处的发病率计算标准化发病率比。所有统计检验均为双侧检验。

结果

退化程度的分布情况为：1627名（18.6%）女性无退化，5197名（59.5%）女性部分退化，1912名（21.9%）女性完全退化。退化增加与年龄增长呈正相关，与产次呈负相关（均P<0.001）。与爱荷华州SEER人群相比，8736名女性的整个队列的相对风险为(1.40)（95%置信区间[CI] = 1.30至1.51）。乳腺癌风险与退化程度相关（无退化时，RR[即观察值与预期值之比]=1.88，95%置信区间[CI]=1.59至2.21；部分退化时，RR = 1.47，95% CI = 1.33至1.61；完全退化时，RR = 0.91，95% CI = 0.75至1.10；异质性检验P<0.001）。小叶退化在所有亚组中均改变了风险（例如，在非典型增生女性中，无退化时，RR = 7.79，95% CI = 3.56至14.81；部分退化时，RR = 4.06，95% CI = 3.03至5.33；完全退化时，RR = 1.49，95% CI = 0.41至3.82；P = 0.003）。