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母乳喂养、生育次数与西班牙队列乳腺癌亚型的关系

Breast feeding, parity and breast cancer subtypes in a Spanish cohort.

机构信息

Oncology and Genetics Unit, Genomic Medicine Group, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.

出版信息

PLoS One. 2012;7(7):e40543. doi: 10.1371/journal.pone.0040543. Epub 2012 Jul 11.

Abstract

BACKGROUND

Differences in the incidence and outcome of breast cancer among Hispanic women compared with white women are well documented and are likely explained by ethnic differences in genetic composition, lifestyle, or environmental exposures. METHODOLGY/PRINCIPAL FINDINGS: A population-based study was conducted in Galicia, Spain. A total of 510 women diagnosed with operable invasive breast cancer between 1997 and 2010 participated in the study. Data on demographics, breast cancer risk factors, and clinico-pathological characteristics were collected. The different breast cancer tumor subtypes were compared on their clinico-pathological characteristics and risk factor profiles, particularly reproductive variables and breastfeeding. Among the 501 breast cancer patients (with known ER and PR receptors), 85% were ER+/PR+ and 15% were ER-&PR-. Among the 405 breast cancer with known ER, PR and HER2 status, 71% were ER+/PR+/HER2- (luminal A), 14% were ER+/PR+/HER2+ (luminal B), 10% were ER-/PR-/HER2- (triple negative breast cancer, TNBC), and 5% were ER-/PR-/HER2+ (non-luminal). A lifetime breastfeeding period equal to or longer than 7 months was less frequent in case patients with TNBC (OR = 0.25, 95% CI = 0.08-0.68) compared to luminal A breast cancers. Both a low (2 or fewer pregnancies) and a high (3-4 pregnancies) number of pregnancies combined with a long breastfeeding period were associated with reduced odds of TNBC compared with luminal A breast cancer, although the association seemed to be slightly more pronounced among women with a low number of pregnancies (OR = 0.09, 95% CI = 0.005-0.54).

CONCLUSIONS/SIGNIFICANCE: In case-case analyses with the luminal A cases as the reference group, we observed a lower proportion of TNBC among women who breastfed 7 or more months. The combination of longer breastfeeding duration and lower parity seemed to further reduce the odds of having a TNBC compared to a luminal A breast cancer.

摘要

背景

西班牙加利西亚开展了一项基于人群的研究。研究共纳入 510 名于 1997 年至 2010 年间诊断为可手术浸润性乳腺癌的女性患者。研究收集了患者的人口统计学资料、乳腺癌危险因素以及临床病理特征等数据。比较了不同乳腺癌肿瘤亚型的临床病理特征和危险因素谱,特别是生殖变量和母乳喂养。在 501 例已知雌激素受体(ER)和孕激素受体(PR)状态的乳腺癌患者中,85%为 ER+/PR+,15%为 ER-/PR-。在 405 例已知 ER、PR 和人表皮生长因子受体 2(HER2)状态的乳腺癌患者中,71%为 ER+/PR+/HER2-(管腔 A 型),14%为 ER+/PR+/HER2+(管腔 B 型),10%为 ER-/PR-/HER2-(三阴性乳腺癌,TNBC),5%为 ER-/PR-/HER2+(非管腔型)。与管腔 A 型乳腺癌相比,TNBC 患者终生母乳喂养期等于或长于 7 个月的比例较低(比值比[OR] = 0.25,95%置信区间[CI] = 0.08-0.68)。与管腔 A 型乳腺癌相比,妊娠次数少(2 次或更少)和多(3-4 次)与母乳喂养时间长均与 TNBC 风险降低相关,尽管这种关联在妊娠次数少的女性中似乎更为明显(OR = 0.09,95%CI = 0.005-0.54)。

结论

与管腔 A 型病例作为参考组的病例对照分析中,我们观察到母乳喂养 7 个月或以上的女性中 TNBC 比例较低。与管腔 A 型乳腺癌相比,较长的母乳喂养时间和较低的产次组合似乎进一步降低了 TNBC 的发病风险。

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