Tseng Marilyn, Byrne Celia, Evers Kathryn A, Daly Mary B
Division of Population Science, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
Breast Cancer Res. 2007;9(5):R72. doi: 10.1186/bcr1781.
Women with a family history of breast cancer may be at higher risk for breast cancer, but few previous studies evaluating diet and breast cancer have focused on such women. The objective of the present study was to determine whether diet, a modifiable risk factor, is related to breast density among women at high genetic risk for breast cancer.
Women with at least one first-degree or second-degree relative with breast cancer or ovarian cancer participating in the Fox Chase Cancer Center Family Risk Assessment Program completed health history and food frequency questionnaires and received standard screening mammograms. Cranial-caudal mammographic images were classified into the four Breast Imaging Reporting and Data System categories ranging from 'entirely fatty' to 'extremely dense'. Logistic regression analysis using proportional odds models for polychotomous outcomes provided estimates of odds ratios for having a higher category versus a lower category of breast density.
Among 157 high-risk women, breast density was inversely associated with vitamin D intake (odds ratio for third tertile versus first tertile, 0.5; 95% confidence interval, 0.2-1.0). In contrast, intakes above the median level for protein (odds ratio, 3.0; 95% confidence interval, 1.3-6.9) and above the median level for animal protein (odds ratio, 4.3; 95% confidence interval, 1.8-10.3) were associated with higher breast density, but only among women whose family history did not reflect a known familial cancer syndrome or a breast cancer predisposition gene.
For women with a strong family history that was not associated with known cancer syndromes, dietary factors may be associated with breast density, a strong predictor of breast cancer risk. Since women with strong family history are often very motivated to change their lifestyle habits, further studies are needed to confirm whether changes in diet will change the breast density and the subsequent onset of breast cancer in these women.
有乳腺癌家族史的女性患乳腺癌的风险可能更高,但以往很少有评估饮食与乳腺癌关系的研究关注这类女性。本研究的目的是确定饮食这一可改变的风险因素是否与乳腺癌高遗传风险女性的乳腺密度有关。
参加福克斯蔡斯癌症中心家族风险评估项目、有至少一位患乳腺癌或卵巢癌的一级或二级亲属的女性,完成健康史和食物频率问卷,并接受标准乳腺筛查钼靶检查。头尾位乳腺钼靶图像被分为从“完全脂肪型”到“极度致密型”的四个乳腺影像报告和数据系统类别。使用多分类结局的比例优势模型进行逻辑回归分析,提供了乳腺密度较高类别与较低类别相比的优势比估计值。
在157名高危女性中,乳腺密度与维生素D摄入量呈负相关(第三分位与第一分位相比的优势比为0.5;95%置信区间为0.2 - 1.0)。相比之下,蛋白质摄入量高于中位数水平(优势比为3.0;95%置信区间为1.3 - 6.9)以及动物蛋白摄入量高于中位数水平(优势比为4.3;95%置信区间为1.8 - 10.3)与较高的乳腺密度相关,但仅在家族史未反映已知家族性癌症综合征或乳腺癌易感基因的女性中如此。
对于家族史与已知癌症综合征无关的女性,饮食因素可能与乳腺密度有关,而乳腺密度是乳腺癌风险的有力预测指标。由于家族史强烈的女性通常非常有动力改变生活方式习惯,因此需要进一步研究来确认饮食改变是否会改变这些女性的乳腺密度以及随后乳腺癌的发病情况。