Rosato Valentina, Bosetti Cristina, Negri Eva, Talamini Renato, Dal Maso Luigino, Malvezzi Matteo, Falcini Fabio, Montella Maurizio, La Vecchia Carlo
aDepartment of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri' bDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan cUnit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano (PN) dRegistro Tumori della Romagna, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola (FO) eUnit of Epidemiology, Istituto Tumori 'Fondazione Pascale', Naples, Italy.
Eur J Cancer Prev. 2014 Sep;23(5):412-7. doi: 10.1097/CEJ.0b013e3283639f7a.
The aim of this study was to investigate the association between breast cancer risk, reproductive factors, and family history of breast cancer by the estrogen receptor (ER) and progesterone receptor (PR) status. We analyzed data from an Italian case-control study including 1075 women with incident breast cancer and 1477 hospital controls. We estimated the odds ratios (ORs) of breast cancer using unconditional logistic regression models including major recognized risk factors for breast cancer. Stronger associations with ER+ than with ER- breast cancer were observed for parity (OR: 0.7 vs. 0.9 for ≥ 3 births vs. nulliparae), age at first birth (OR: 1.6 vs. 1.2 for age ≥ 30 vs. <25 years), menopausal status (OR: 0.7 vs. 0.8 for postmenopause vs. pre/perimenopause), age at menopause (OR: 1.3 vs. 1.2 for menopause at age ≥ 50 vs. <50 years), and family history of breast cancer (OR: 2.2 vs. 1.4). Among the ER+ patients, the presence of PR+ did not appreciably modify any of the risk estimates. The association with age at menarche and hormone replacement therapy use was neither significant nor heterogeneous across ER and PR subtypes. In conclusion, we found stronger associations with selected menstrual and reproductive factors for ER+ (PR+) than for ER- (PR-) breast cancers, though in the absence of significant heterogeneity.
本研究旨在通过雌激素受体(ER)和孕激素受体(PR)状态,调查乳腺癌风险、生殖因素与乳腺癌家族史之间的关联。我们分析了一项意大利病例对照研究的数据,该研究纳入了1075例新发乳腺癌女性患者和1477例医院对照。我们使用无条件逻辑回归模型估计乳腺癌的比值比(OR),该模型纳入了公认的主要乳腺癌风险因素。对于ER阳性乳腺癌,产次(≥3次分娩与未生育相比,OR:0.7对0.9)、初产年龄(≥30岁与<25岁相比,OR:1.6对1.2)、绝经状态(绝经后与绝经前/围绝经期相比,OR:0.7对0.8)、绝经年龄(≥50岁绝经与<50岁绝经相比,OR:1.3对1.2)以及乳腺癌家族史(OR:2.2对1.4)的关联比ER阴性乳腺癌更强。在ER阳性患者中,PR阳性的存在并未明显改变任何风险估计值。月经初潮年龄和激素替代疗法使用与乳腺癌的关联在ER和PR亚型中既不显著也无差异。总之,我们发现与ER阳性(PR阳性)乳腺癌相比,ER阴性(PR阴性)乳腺癌与特定月经和生殖因素的关联更强,尽管不存在显著差异。