Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska University Hospital and Institute, T2, Stockholm, SE-171 76, Sweden.
Breast Cancer Res. 2010;12(1):R14. doi: 10.1186/bcr2481. Epub 2010 Feb 25.
Diabetes during pregnancy is related to enhanced fetal growth, which has been associated with increased breast cancer risk. Whether daughters of mothers with a diagnosis of diabetes have an increased risk of breast cancer is not known.
We performed a retrospective cohort study of daughters of mothers with diabetes by linkage of the Swedish Multigeneration, Cause-of-Death and Patient Register between 1952 and 2005. Breast cancer cases were ascertained by linkage with the Swedish Cancer Register between 1958 and 2005. Standardized incidence ratios (SIRs) of breast cancer were calculated assuming a Poisson distribution for the observed cases.
We identified 291,360 daughters of mothers with a diagnosis of diabetes before or after birth between 1952 and 2005. Among the daughters, 7,956 cases of breast cancer were diagnosed between 1964 and 2005. The total time of follow-up was 12,173,821 person years. The expected number of breast cancer cases was 9,204, resulting in an SIR of 0.86 (95% CI, 0.85 to 0.88). The decrease in risk associated with maternal diabetes was stronger for premenopausal (< 55 years of age) than postmenopausal (> or = 55 years of age) breast cancer (SIR 0.83 and 0.91, respectively). Among daughters of mothers with diabetes, a history of breast cancer in the mother increased the risk of breast cancer in the daughter (SIR 1.43, 1.32 to 1.54).
Daughters of mothers with a lifetime history of diabetes were at a decreased risk of breast cancer. The strongest negative association was found among premenopausal breast cancer.
妊娠糖尿病与胎儿生长加速有关，而后者与乳腺癌风险增加相关。患有糖尿病的母亲的女儿是否具有更高的乳腺癌风险尚不清楚。
我们通过瑞典多代、死因和患者登记处（1952 年至 2005 年）的链接，对患有糖尿病的母亲的女儿进行了回顾性队列研究。通过与瑞典癌症登记处（1958 年至 2005 年）的链接，确定乳腺癌病例。使用泊松分布假设对观察到的病例计算乳腺癌的标准化发病比（SIR）。
我们在 1952 年至 2005 年期间发现了 291360 名患有糖尿病的母亲在出生前后的女儿。在这些女儿中，1964 年至 2005 年期间诊断出 7956 例乳腺癌。总随访时间为 12173821 人年。预期乳腺癌病例数为 9204 例，SIR 为 0.86（95%CI，0.85 至 0.88）。与母亲糖尿病相关的风险降低在绝经前（<55 岁）乳腺癌比绝经后（≥55 岁）乳腺癌更强（SIR 分别为 0.83 和 0.91）。在患有糖尿病的母亲的女儿中，母亲的乳腺癌病史增加了女儿患乳腺癌的风险（SIR 为 1.43，1.32 至 1.54）。
患有糖尿病的母亲的女儿患乳腺癌的风险降低。绝经前乳腺癌的关联最强。
