Lampe Johanna W, Nishino Yoshikazu, Ray Roberta M, Wu Chunyuan, Li Wenjin, Lin Ming-Gang, Gao Dao Li, Hu Yongwei, Shannon Jackilen, Stalsberg Helge, Porter Peggy L, Frankenfeld Cara L, Wähälä Kristiina, Thomas David B
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
Cancer Epidemiol Biomarkers Prev. 2007 Dec;16(12):2579-86. doi: 10.1158/1055-9965.EPI-07-0368.
Proliferative benign breast conditions are associated with elevated risk of breast cancer, whereas nonproliferative conditions are not strongly associated with risk. Factors acting before onset of hyperplasia might be associated with both benign conditions and breast cancer, whereas those on the proliferative disease-to-cancer pathway would be associated only with cancer. Soy isoflavone exposure may influence breast cancer risk, but little is known of its association with benign conditions.
We examined possible relationships between plasma genistein and daidzein concentrations and risk of breast disease in women, in a breast self-examination trial in Shanghai, China, diagnosed with breast cancer (n = 196) or a benign breast condition (n = 304), and 1,002 age-matched controls with no known breast disease. Benign conditions were classified as nonproliferative (n = 131) or proliferative with or without atypia (n = 173).
Isoflavone concentrations were inversely associated with risk of nonproliferative and proliferative benign fibrocystic conditions, as well as with breast cancer, both with and without concomitant proliferative changes in ipsilateral noncancerous mammary epithelium (P(trend) < 0.01 for all comparisons with controls). Women in the highest quartile of plasma genistein (>76.95 ng/mL) were less likely to have breast cancer (odds ratio, 0.26; 95% confidence interval, 0.13-0.50) or benign conditions (odds ratio, 0.40; 95% confidence interval, 0.23-0.70) compared with women in the lowest quartile (<9.42 ng/mL). Observed risks for breast cancer with and without surrounding proliferative changes were not different, respectively, from observed risks for benign proliferative and nonproliferative conditions alone.
Isoflavone exposure was inversely associated with fibrocystic breast conditions and breast cancer, and the results suggest that effects on cancer risk occur early in carcinogenesis.
增殖性乳腺良性病变与乳腺癌风险升高相关，而非增殖性病变与风险无强关联。增生开始前起作用的因素可能与良性病变和乳腺癌均相关，而增殖性疾病至癌症途径中的因素仅与癌症相关。大豆异黄酮暴露可能影响乳腺癌风险，但其与良性病变的关联知之甚少。
在中国上海的一项乳房自我检查试验中，我们检查了血浆染料木黄酮和大豆苷元浓度与女性乳腺疾病风险之间的可能关系，该试验纳入了被诊断为乳腺癌（n = 196）或乳腺良性病变（n = 304）的女性，以及1002名年龄匹配且无已知乳腺疾病的对照者。良性病变分为非增殖性（n = 131）或有或无非典型增生的增殖性（n = 173）。
异黄酮浓度与非增殖性和增殖性乳腺纤维囊性病变的风险呈负相关，也与乳腺癌呈负相关，无论同侧非癌性乳腺上皮是否伴有增殖性改变（与对照者的所有比较中，P趋势<0.01）。血浆染料木黄酮最高四分位数（>76.95 ng/mL）的女性与最低四分位数（<9.42 ng/mL）的女性相比，患乳腺癌的可能性较小（比值比，0.26；95%置信区间，0.13 - 0.50）或患良性病变的可能性较小（比值比，0.40；95%置信区间，0.23 - 0.70）。伴有和不伴有周围增殖性改变的乳腺癌观察到的风险分别与单独观察到的良性增殖性和非增殖性病变的风险无差异。
异黄酮暴露与乳腺纤维囊性病变和乳腺癌呈负相关，结果表明对癌症风险的影响在致癌过程早期就已发生。
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