Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
Breast Cancer Res Treat. 2011 Dec;130(3):965-74. doi: 10.1007/s10549-011-1664-2. Epub 2011 Jul 12.
Growth and development factors could contribute to the development of breast cancer associated with an increase in mammographic density. This study examines the influence of certain childhood-related, socio-demographic and anthropometric variables on mammographic density in adult woman. The study covered 3574 women aged 45-68 years, participating in breast cancer-screening programmes in seven Spanish cities. Based on a craniocaudal mammogram, blind, anonymous measurement of mammographic density was made by a single radiologist, using Boyd's semiquantitative scale. Data associated with the early stages of life were obtained from a direct survey. Ordinal logistic regression and generalised linear models were employed to estimate the association between mammographic density and the variables covered by the questionnaire. Screening programme was introduced as a random effects term. Age, number of children, body mass index (BMI) and other childhood-related variables were used as adjustment variables, and stratified by menopausal status. A total of 811 women (23%) presented mammographic density of over 50%, and 5% of densities exceeded 75%. Our results show a greater prevalence of high mammographic density in women with low prepubertal weight (OR: 1.18; 95% CI: 1.02-1.36); marked prepubertal height (OR: 1.25; 95% CI: 0.97-1.60) and advanced age of their mothers at their birth (>39 years: OR: 1.28; 95% CI: 1.03-1.60); and a lower prevalence of high mammographic density in women with higher prepubertal weight, low birth weight and earlier menarche. The influence of these early-life factors may be explained by greater exposure to hormones and growth factors during the development of the breast gland, when breast tissue would be particularly susceptible to proliferative and carcinogenic stimulus.
生长和发育因子可能导致与乳腺密度增加相关的乳腺癌的发生。本研究旨在探讨某些与儿童期相关的、社会人口学和人体测量学变量对成年女性乳腺密度的影响。该研究纳入了来自西班牙七个城市参加乳腺癌筛查项目的 3574 名 45-68 岁女性。通过头尾位乳腺 X 线片,由一名放射科医生对乳腺密度进行盲法、匿名测量,采用 Boyd 半定量评分法。通过直接问卷调查获取与生命早期相关的数据。采用有序逻辑回归和广义线性模型来估计乳腺密度与问卷涵盖变量之间的关联。筛查项目被作为随机效应项。年龄、子女数量、体重指数(BMI)和其他与儿童期相关的变量被用作调整变量,并按绝经状态进行分层。共有 811 名(23%)女性的乳腺密度超过 50%,5%的女性乳腺密度超过 75%。我们的结果表明,青春期前体重较低(比值比[OR]:1.18;95%置信区间[CI]:1.02-1.36)、青春期前身高较高(OR:1.25;95% CI:0.97-1.60)和母亲分娩时年龄较大(>39 岁:OR:1.28;95% CI:1.03-1.60)的女性中,高度乳腺密度的患病率更高;而青春期前体重较高、出生体重较低和初潮较早的女性中,高度乳腺密度的患病率较低。这些生命早期因素的影响可能与乳腺腺体发育过程中暴露于更多的激素和生长因子有关,因为此时乳腺组织特别容易受到增殖和致癌刺激的影响。