Lv Mengmeng, Zhu Xingya, Zhong Shanliang, Chen Weixian, Hu Qing, Ma Tengfei, Zhang Jun, Zhang Xiaohui, Tang Jinhai, Zhao Jianhua
Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital, Cancer Institute of Jiangsu Province, Nanjing, China; The First Clinical School of Nanjing Medical University, Nanjing, China.
The First Clinical School of Nanjing Medical University, Nanjing, China; Gulou Clinical Medical College, Nanjing Medical University, Nanjing, China.
PLoS One. 2014 Jul 14;9(7):e102503. doi: 10.1371/journal.pone.0102503. eCollection 2014.
The relationship between radial scars and breast cancer is unclear, as the results of different studies are inconsistent. We aim to solve the controversy and assess the breast cancer risk of radial scars.
Case-control or cohort studies about radial scars and breast cancer risk published in PubMed, Web of Science and the Cochrane Library from 2000 to 2013 were searched. Heterogeneity for the eligible data was assessed and a pooled odds ratio (OR) with 95% confidence interval (CI) was calculated.
Five observational studies involving 2521 cases and 20290 controls were included in our study. From pooled analysis, radial scars were found to have a 1.33 fold increased risk of breast cancer, but which was not significant (P = 0.138). Sample size contributed to heterogeneity. In subgroup analysis, the results pooled from studies with sample size >2000 show that presence of radial scars was associated with 1.6 times breast cancer risk compared to absence of radial scars. Radial scars increased the risk of breast cancer among women with proliferative disease without atypia, but no significant association between radial scars and carcinoma was noted among women with atypical hyperplasia.
Radial scars tend to be associated with an increased breast cancer risk. Radial scars should be considered among women with proliferative disease without atypia, while atypical hyperplasia is still the primary concern among women with both radial scars and atypical hyperplasia.
由于不同研究结果不一致,放射状瘢痕与乳腺癌之间的关系尚不清楚。我们旨在解决这一争议并评估放射状瘢痕的乳腺癌风险。
检索2000年至2013年发表在PubMed、科学网和考克兰图书馆上关于放射状瘢痕与乳腺癌风险的病例对照或队列研究。对符合条件的数据进行异质性评估,并计算合并比值比(OR)及95%置信区间(CI)。
我们的研究纳入了五项观察性研究,涉及2521例病例和20290例对照。通过汇总分析发现,放射状瘢痕使患乳腺癌的风险增加1.33倍,但差异无统计学意义(P = 0.138)。样本量导致了异质性。在亚组分析中,样本量>2000的研究汇总结果显示,存在放射状瘢痕者患乳腺癌的风险是不存在放射状瘢痕者的1.6倍。放射状瘢痕增加了无非典型增生的增生性疾病女性患乳腺癌的风险,但在有非典型增生的女性中,未发现放射状瘢痕与癌症之间存在显著关联。
放射状瘢痕往往与乳腺癌风险增加有关。对于无非典型增生的增生性疾病女性,应考虑放射状瘢痕因素,而对于既有放射状瘢痕又有非典型增生的女性,非典型增生仍是主要关注点。