Fred Hutchinson Cancer Research Center, 1100 N Fairview Ave, M4-C308, Seattle, WA 98109-1024, USA.
J Clin Oncol. 2010 Feb 20;28(6):1005-10. doi: 10.1200/JCO.2009.25.0423. Epub 2010 Jan 25.
PURPOSE Both migraine and breast cancer are hormonally mediated. Two recent reports indicate that women with a migraine history may have a lower risk of postmenopausal breast cancer than those who never suffered migraines. This finding requires confirmation; in particular, an assessment of the influence of use of nonsteroidal anti-inflammatory drugs (NSAID) is needed, because many studies indicate that NSAID use also may confer a reduction in breast cancer risk. METHODS We assessed the relationship between self-reported history of migraine and incidence of postmenopausal breast cancer in 91,116 women enrolled on the Women's Health Initiative Observational Study prospective cohort from 1993 to 1998 at ages 50 to 79 years. Through September 15, 2005, there were 4,006 eligible patients with breast cancer diagnosed. Results Women with a history of migraine had a lower risk of breast cancer (hazard ratio [HR], 0.89; 95% CI, 0.80 to 98) than women without a migraine history. This risk did not vary by recent NSAID use. The lower risk was somewhat more pronounced for invasive estrogen-receptor-positive and progesterone-receptor-positive tumors (HR, 0.83; 95% CI, 0.71 to 0.97), as no reduction in risk was observed for invasive ER-negative/PR-negative tumors (HR, 1.16; 95% CI, 0.86 to 1.57), and this difference in risk estimates was borderline statistically significant (P = .06). CONCLUSION This study supports the hypothesis that a history of migraine is associated with a lower risk of breast cancer and that this relationship is independent of recent NSAID use.
偏头痛和乳腺癌均受激素调节。最近有两项报告指出,有偏头痛病史的女性绝经后患乳腺癌的风险可能低于从未患过偏头痛的女性。这一发现需要进一步证实;特别是需要评估非甾体抗炎药(NSAID)使用的影响,因为许多研究表明 NSAID 的使用也可能降低乳腺癌的风险。
我们评估了 1993 年至 1998 年期间参加妇女健康倡议观察性研究前瞻性队列的 91116 名年龄在 50 至 79 岁的女性中,自我报告的偏头痛病史与绝经后患乳腺癌的发病率之间的关系。截至 2005 年 9 月 15 日,有 4006 例符合条件的乳腺癌患者被诊断。
有偏头痛病史的女性患乳腺癌的风险较低(风险比 [HR],0.89;95%CI,0.80 至 98),而没有偏头痛病史的女性风险较高。这种风险与近期 NSAID 使用无关。对于侵袭性雌激素受体阳性和孕激素受体阳性肿瘤,风险降低更为明显(HR,0.83;95%CI,0.71 至 0.97),而对于侵袭性雌激素受体阴性/孕激素受体阴性肿瘤,风险并未降低(HR,1.16;95%CI,0.86 至 1.57),并且风险估计值的差异具有统计学意义(P =.06)。
这项研究支持这样一种假设,即偏头痛病史与乳腺癌风险降低有关,且这种关系独立于近期 NSAID 使用。