Byrne C, Brinton L A, Haile R W, Schairer C
Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892.
Epidemiology. 1991 Jul;2(4):276-84. doi: 10.1097/00001648-199107000-00007.
We studied the effects of family history on breast cancer risk among 2,908 cases and 3,180 controls, selected from participants in a nationwide screening project. First-degree family history was associated with a twofold risk increase. Second-degree family history effects were minimal, after adjusting for effects of first-degree relatives. Family history effects were not confounded by age at menarche, age at first full-term birth, age at natural menopause, or previous benign breast disease. Risks from mother's and sister's history were independent. The odds ratio (OR) from a maternal history, 1.9 (95% confidence interval [CI]: 1.6-2.3), varied little by the subject's age at diagnosis, menopause status, or disease laterality. Interactions of maternal history effects with multiple breast biopsies and age at menopause were greater than additive, indicating common mechanistic pathways. The OR from a sister's history was 2.3 (95% CI: 1.9-2.8) and was increased among women who were less than 45 (OR = 6.9), had bilateral disease (OR = 4.7), or were premenopausal (OR = 4.4). The effects from a mother's history and a sister's history are modified in different directions by different factors, providing further indication of the separate roles of a mother's and sister's history in breast cancer etiology.
我们研究了家族史对2908例病例和3180例对照者患乳腺癌风险的影响，这些病例和对照者选自一项全国性筛查项目的参与者。一级家族史与风险增加两倍相关。在调整了一级亲属的影响后，二级家族史的影响最小。家族史的影响不受初潮年龄、首次足月产年龄、自然绝经年龄或既往良性乳腺疾病的干扰。母亲和姐妹家族史导致的风险是独立的。母亲家族史的比值比（OR）为1.9（95%置信区间[CI]：1.6 - 2.3），在诊断时的年龄、绝经状态或疾病部位方面变化不大。母亲家族史的影响与多次乳腺活检和绝经年龄之间的相互作用大于相加作用，表明存在共同的机制途径。姐妹家族史的OR为2.3（95% CI：1.9 - 2.8），在年龄小于45岁（OR = 6.9）、患有双侧疾病（OR = 4.7）或处于绝经前（OR = 4.4）的女性中有所增加。母亲家族史和姐妹家族史的影响因不同因素而朝着不同方向改变，这进一步表明了母亲家族史和姐妹家族史在乳腺癌病因学中的不同作用。
