Bertelsen Lisbeth, Mellemkjaer Lene, Balslev Eva, Olsen Jørgen H
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
Am J Epidemiol. 2008 Aug 1;168(3):261-7. doi: 10.1093/aje/kwn133. Epub 2008 Jun 4.
Benign breast disease is associated with increased risk of breast cancer. To further clarify whether there is a genetic link between benign and malignant breast lesions, the authors identified 14,648 first-degree female relatives of 8,807 patients in whom breast cancer was diagnosed at <50 years of age by using Danish nationwide cancer and population registers. Hospital register data were used to follow the relatives for occurrence of benign breast disease from 1977 to 2003 and to calculate rates of benign breast disease in the general population of Danish women for comparison. Risk for relatives was increased for benign breast diseases (observed/expected ratio = 1.54, 95% confidence interval: 1.42, 1.66), particularly for relatives aged <40 years. Higher risks were observed after breast cancer had been diagnosed in the family; however, an increased risk for relatives aged <50 years (observed/expected ratio = 1.24, 95% confidence interval: 1.02, 1.51) was present before breast cancer was diagnosed in the family. Enhanced surveillance of close relatives of breast cancer patients seems to be an important factor to address when investigating the association between benign breast disease and familial breast cancer. A genetic link between benign breast disease and breast cancer was indicated by our data but needs to be confirmed in future studies.
良性乳腺疾病与乳腺癌风险增加相关。为进一步阐明良性和恶性乳腺病变之间是否存在遗传联系，作者利用丹麦全国癌症和人口登记册，确定了8807例50岁之前被诊断为乳腺癌的患者的14648名一级女性亲属。利用医院登记数据追踪这些亲属在1977年至2003年期间良性乳腺疾病的发生情况，并计算丹麦女性普通人群中良性乳腺疾病的发病率以作比较。亲属患良性乳腺疾病的风险增加（观察值/预期值比=1.54，95%置信区间：1.42，1.66），尤其是40岁以下的亲属。在家族中诊断出乳腺癌后观察到更高的风险；然而，在家族中诊断出乳腺癌之前，50岁以下亲属的风险就已增加（观察值/预期值比=1.24，95%置信区间：1.02，1.51）。在调查良性乳腺疾病与家族性乳腺癌之间的关联时，加强对乳腺癌患者近亲的监测似乎是一个需要考虑的重要因素。我们的数据表明良性乳腺疾病与乳腺癌之间存在遗传联系，但需要在未来的研究中加以证实。
