Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Mol Carcinog. 2011 Apr;50(4):280-90. doi: 10.1002/mc.20639. Epub 2010 May 24.
Breast cancer, the most common cancer in women, results from combined effects of genetic and environmental factors. Although a number of preventive measures have been suggested to reduce the risk of breast cancer, only a few (e.g., regular mammogram, etc.) proved to be efficient preventive modalities. Among many potential reasons, differences in individual susceptibility factors may complicate the efficacy of the intervention. A growing body of evidence shows that the strength of association between various dietary, behavioral (exercise and obesity), and environmental exposures, and breast cancer risk may be modified by individual genetic factors. Preventive strategies against breast cancer will be discussed considering the findings of the gene-environment interaction of breast cancer. These include behavior modification for high-risk subjects (primary prevention), early detection and extensive monitoring of genetically susceptible subjects and noninvasive treatment of early stage cancer cases (secondary prevention), and finally prophylactic and therapeutic intervention to slow the progression of diseases (tertiary prevention). The accumulating evidences of the gene-environment interactions provide a better understanding of the breast cancer development and enable us to adopt individualized preventive strategies for personalized health care.
乳腺癌是女性最常见的癌症,是遗传和环境因素综合作用的结果。尽管已经提出了许多预防措施来降低乳腺癌的风险,但只有少数措施(如定期乳房 X 光检查等)被证明是有效的预防方法。在许多潜在的原因中,个体易感性因素的差异可能会使干预的效果复杂化。越来越多的证据表明,各种饮食、行为(运动和肥胖)和环境暴露与乳腺癌风险之间的关联强度可能受到个体遗传因素的影响。考虑到乳腺癌基因-环境相互作用的研究结果,我们将讨论预防乳腺癌的策略。这些策略包括对高危人群进行行为改变(一级预防)、对遗传易感人群进行早期检测和广泛监测以及对早期癌症病例进行非侵入性治疗(二级预防),最后是预防和治疗干预以减缓疾病进展(三级预防)。基因-环境相互作用的累积证据提供了对乳腺癌发展的更好理解,并使我们能够为个性化医疗采用个体化预防策略。