Beaber Elisabeth F, Holt Victoria L, Malone Kathleen E, Porter Peggy L, Daling Janet R, Li Christopher I
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-C308, P.O. Box 19024, Seattle, WA 98109-1024, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3427-34. doi: 10.1158/1055-9965.EPI-08-0641.
Numerous studies have evaluated the association between factors related to maturation and reproduction and breast cancer risk, but few have assessed how these factors are related to different histologic types of breast cancer among postmenopausal women. We used polytomous logistic regression to assess the effect of age at maximum height and reproductive factors on risk of invasive breast cancer by histologic type in three case groups (524 ductal, 324 lobular, and 196 ductal-lobular) and 469 controls enrolled in a population-based case-control study of women ages 55 to 74 years residing in the Seattle-Puget Sound region of Washington State (2000-2004). Histologic type was determined by a centralized tissue review for 83% of cases. Age at menarche and age at maximum height were inversely associated with risk of ductal-lobular carcinoma (P(trend) = 0.04 for both exposures) but not ductal or lobular carcinoma. Relative to nulliparous women, parous women had a 50% reduced risk of all histologic types of breast cancer. We observed similar increases in risk across histologic types associated with having a first live birth at ages > or = 30 years compared with ages < or = 19 years. Compared with parous women who never breast-fed, those who breast-fed had a reduced risk of ductal carcinoma (odds ratio, 0.7; 95% confidence interval, 0.5-0.9) but not lobular or ductal-lobular carcinoma. Further exploration of breast cancer risk by histology is merited to understand differences in the etiology of ductal, lobular, and ductal-lobular carcinoma.
众多研究评估了与成熟和生殖相关的因素与乳腺癌风险之间的关联,但很少有研究评估这些因素在绝经后女性中如何与不同组织学类型的乳腺癌相关。我们采用多分类逻辑回归,在一项基于人群的病例对照研究中,对55至74岁居住在华盛顿州西雅图 - 普吉特海湾地区(2000 - 2004年)的女性的三个病例组(524例导管癌、324例小叶癌和196例导管 - 小叶癌)和469名对照,评估达到最大身高时的年龄和生殖因素对不同组织学类型浸润性乳腺癌风险的影响。83%的病例通过集中组织审查确定组织学类型。初潮年龄和达到最大身高时的年龄与导管 - 小叶癌风险呈负相关(两种暴露的P趋势均为0.04),但与导管癌或小叶癌无关。与未生育女性相比,生育过的女性患所有组织学类型乳腺癌的风险降低50%。我们观察到,与在≤19岁时首次生育相比,在≥30岁时首次生育的女性,所有组织学类型的乳腺癌风险均有类似程度的增加。与从未母乳喂养的生育女性相比,进行母乳喂养的女性患导管癌的风险降低(比值比为0.7;95%置信区间为0.5 - 0.9),但患小叶癌或导管 - 小叶癌的风险未降低。值得进一步按组织学类型探索乳腺癌风险,以了解导管癌、小叶癌和导管 - 小叶癌病因的差异。