Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
Cancer Causes Control. 2010 Jun;21(6):839-46. doi: 10.1007/s10552-010-9510-0. Epub 2010 Feb 4.
Reproductive factors, such as early age at menarche, late age at menopause, and nulliparity are known risk factors for breast cancer. Previously, we reported these factors to be associated with risk of developing contralateral breast cancer (CBC). In this study, we evaluated the association between these factors and CBC risk among BRCA1 and BRCA2 (BRCA1/2) mutation carriers and non-carriers.
The WECARE Study is a population-based multi-center case-control study of 705 women with CBC (cases) and 1,397 women with unilateral breast cancer (controls). All participants were screened for BRCA1/2 mutations and 181 carriers were identified. Conditional logistic regression models were used to evaluate associations between reproductive factors and CBC for mutation carriers and non-carriers.
None of the associations between reproductive factors and CBC risk differed between mutation carriers and non-carriers. The increase in risk with younger age at menarche and decrease in risk in women with more than two full-term pregnancies seen in non-carriers were not significantly different in carriers (adjusted RRs = 1.31, 95% CI 0.65-2.65 and 0.53, 95% CI 0.19-1.51, respectively). No significant associations between the other reproductive factors and CBC risk were observed in mutation carriers or non-carriers.
For two reproductive factors previously shown to be associated with CBC risk, we observed similar associations for BRCA1/2 carriers. This suggests that reproductive variables that affect CBC risk may have similar effects in mutation carriers and non-carriers.
初潮年龄早、绝经年龄晚和未生育等生殖因素是乳腺癌的已知危险因素。此前,我们报道这些因素与对侧乳腺癌(CBC)发病风险相关。在这项研究中,我们评估了这些因素与 BRCA1 和 BRCA2(BRCA1/2)突变携带者和非携带者中 CBC 风险之间的关系。
WECARE 研究是一项基于人群的多中心病例对照研究,共纳入 705 例 CBC 患者(病例)和 1397 例单侧乳腺癌患者(对照)。所有参与者均进行了 BRCA1/2 突变筛查,共发现 181 例携带者。采用条件逻辑回归模型评估了生殖因素与 BRCA1/2 突变携带者和非携带者 CBC 之间的关系。
生殖因素与 CBC 风险之间的关联在突变携带者和非携带者之间没有差异。非携带者中初潮年龄较早和足月妊娠次数较多与 CBC 风险增加和降低相关,但在携带者中差异无统计学意义(调整后的 RR 值分别为 1.31、95%CI 0.65-2.65 和 0.53、95%CI 0.19-1.51)。在携带者或非携带者中,其他生殖因素与 CBC 风险之间均无显著关联。
对于两个先前与 CBC 风险相关的生殖因素,我们在 BRCA1/2 携带者中观察到了相似的关联。这表明,影响 CBC 风险的生殖变量可能在突变携带者和非携带者中有相似的作用。