Yanhua Che, Geater Alan, You Jing, Li Li, Shaoqiang Zhou, Chongsuvivatwong Virasakdi, Sriplung Hutcha
Breast Department, The First Peoples' Hospital of Kunming, Yunnan province, PR China.
Asian Pac J Cancer Prev. 2012;13(5):2179-84. doi: 10.7314/apjcp.2012.13.5.2179.
To compare reproductive factor influence on patients with pathological diagnosed malignant and benign tumor in the Breast Department, The First Peoples' Hospital of Kunming in Yunnan province, China.
A hospital-based case-control study was conducted on 263 breast cancer (BC) cases and 457 non-breast cancer controls from 2009 to 2011. The cases and controls information on demographics, medical history, and reproductive characteristics variables were collected using a self-administered questionnaire and routine medical records. Histology of breast cancer tissue and benign breast lesion were documented by pathology reports. Since some variables in data analysis had zero count in at least one category, binomial-response GLM using the bias-reduction method was applied to estimate OR's and their 95% confidence intervals (95% CI). To adjust for age and menopause status, a compound variable comprising age and menopausal status was retained in the statistical models.
multivariate model analysis revealed significant independent positive associations of BC with short menstrual cycle, old age at first live birth, never breastfeeding, history of oral contraception experience, increased number of abortion, postmenopausal status, and nulliparity. Categorised by age and menopausal status, perimenopausal women had about 3-fold and postmenopausal women had more than 5-fold increased risk of BC compared to premenopausal women.
This study has confirmed the significant association of BC and estrogen related risk factors of breast cancer including longer menstrual cycle, older age of first live birth, never breastfeeding, nulliparity, and number of abortions more than one. The findings suggest that female hormonal factors, especially the trend of menopause status play a significant role in the development of BC in Yunnan women.
比较生殖因素对中国云南省昆明市第一人民医院乳腺科病理诊断为恶性和良性肿瘤患者的影响。
2009年至2011年,对263例乳腺癌(BC)患者和457例非乳腺癌对照者进行了一项基于医院的病例对照研究。通过自填问卷和常规病历收集病例和对照者的人口统计学、病史和生殖特征变量信息。乳腺癌组织和乳腺良性病变的组织学由病理报告记录。由于数据分析中的一些变量在至少一个类别中的计数为零,因此应用使用偏差减少方法的二项式响应广义线性模型来估计比值比(OR)及其95%置信区间(95%CI)。为了调整年龄和绝经状态,在统计模型中保留了一个包含年龄和绝经状态的复合变量。
多变量模型分析显示,BC与月经周期短、首次生育年龄大、从未母乳喂养、口服避孕药史、流产次数增加、绝经后状态和未生育显著独立正相关。按年龄和绝经状态分类,与绝经前妇女相比,围绝经期妇女患BC的风险增加约3倍,绝经后妇女患BC的风险增加超过5倍。
本研究证实了BC与乳腺癌雌激素相关危险因素之间的显著关联,这些危险因素包括月经周期延长、首次生育年龄较大、从未母乳喂养、未生育以及流产次数超过一次。研究结果表明,女性激素因素,尤其是绝经状态的变化趋势在云南女性BC的发生中起重要作用。