Dogan Lutfi, Kalaylioglu Zeynep, Karaman Niyazi, Ozaslan Cihangir, Atalay Can, Altinok Mehmet
Department of General Surgery, Ankara Oncology Training and Education Hospital, Ankara, Turkey.
Asian Pac J Cancer Prev. 2011;12(12):3375-80.
Breast cancer is a histological, morphological and molecular heterogenous disease. Like clinical outcomes and prognoses of different subtypes, etiologies might also be different. Therefore, epidemiologic risk factors like sociologic, demographic, antropometric, reproductive, and menstrual factors can be considered as an entity reflected in tumor features. This study was planned to explore the relation between well known risk factors of breast cancer and histological and molecular features of the tumor.
Epidemiologic data for 250 breast cancer patients followed-up by our clinic and 250 healthy individuals without any diagnosis of malignancy were obtained. The data displaying a relation to breast cancer are age, height, weight, body mass index (BMI), place of birth and province, educational level, menstrual status, age of menarche and menopause, number of births, age at first childbirth, family history of breast cancer, history of smoking and hormone treatment, mammographic screening, and presence of benign lesions. The tumor characteristics of patients in the breast cancer group were recorded.
Advanced age, nulliparity, low educational level, irregular mammographic screening, early menarche and late menopause, and high BMI in postmenopausal period were found to be related to increased breast cancer risk. Striking results in terms of the relation between epidemiological factors and tumor features were the early diagnosis of breast cancer in patients with regular mammographic screening. Tumor size was decreased with increased age and increased with increased BMI. Advanced age, prolonged lactation, increased number of births, and high education level were found to decrease axillary involvement.
Multiparity still continues to be the strongest protective factor against breast cancer in our society. The decrease in menarche age may be an early sign of the increased breast cancer incidence. Women should be informed about the relation between postmenopausal obesity and breast cancer and encouraged to attend physical activity and exercise programmes. Regular physical examination and mammographic screening are protective against breast cancer.
乳腺癌是一种组织学、形态学和分子层面均具有异质性的疾病。如同不同亚型的临床结局和预后情况，其病因可能也存在差异。因此，诸如社会学、人口统计学、人体测量学、生殖和月经因素等流行病学风险因素可被视为反映在肿瘤特征中的一个整体。本研究旨在探究乳腺癌的已知风险因素与肿瘤的组织学及分子特征之间的关系。
获取了由我们诊所随访的250例乳腺癌患者以及250例未被诊断为恶性肿瘤的健康个体的流行病学数据。与乳腺癌相关的数据包括年龄、身高、体重、体重指数（BMI）、出生地及省份、教育程度、月经状况、初潮和绝经年龄、生育次数、首次生育年龄、乳腺癌家族史、吸烟史和激素治疗史、乳腺钼靶筛查以及良性病变的存在情况。记录了乳腺癌组患者的肿瘤特征。
发现高龄、未生育、低教育程度、乳腺钼靶筛查不规律、初潮早和绝经晚以及绝经后期高BMI与乳腺癌风险增加相关。在流行病学因素与肿瘤特征的关系方面，显著的结果是乳腺钼靶筛查规律的患者乳腺癌早期诊断率较高。肿瘤大小随年龄增加而减小，随BMI增加而增大。发现高龄、哺乳时间延长、生育次数增加和高教育程度可降低腋窝受累情况。
在我们的社会中，多产仍然是预防乳腺癌最强有力的保护因素。初潮年龄降低可能是乳腺癌发病率上升的早期迹象。应告知女性绝经后肥胖与乳腺癌之间的关系，并鼓励她们参加体育活动和锻炼项目。定期进行体格检查和乳腺钼靶筛查可预防乳腺癌。
