乳腺癌的背景风险以及身体活动与乳腺X线密度之间的关联。
Background risk of breast cancer and the association between physical activity and mammographic density.
作者信息
Trinh Thang, Eriksson Mikael, Darabi Hatef, Bonn Stephanie E, Brand Judith S, Cuzick Jack, Czene Kamila, Sjölander Arvid, Bälter Katarina, Hall Per
机构信息
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, 17177, Sweden.
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
出版信息
Breast Cancer Res. 2015 Apr 2;17(1):50. doi: 10.1186/s13058-015-0565-4.
INTRODUCTION
High physical activity has been shown to decrease the risk of breast cancer, potentially by a mechanism that also reduces mammographic density. We tested the hypothesis that the risk of developing breast cancer in the next 10 years according to the Tyrer-Cuzick prediction model influences the association between physical activity and mammographic density.
METHODS
We conducted a population-based cross-sectional study of 38,913 Swedish women aged 40-74 years. Physical activity was assessed using the validated web-questionnaire Active-Q and mammographic density was measured by the fully automated volumetric Volpara method. The 10-year risk of breast cancer was estimated using the Tyrer-Cuzick (TC) prediction model. Linear regression analyses were performed to assess the association between physical activity and volumetric mammographic density and the potential interaction with the TC breast cancer risk.
RESULTS
Overall, high physical activity was associated with lower absolute dense volume. As compared to women with the lowest total activity level (<40 metabolic equivalent hours [MET-h] per day), women with the highest total activity level (≥50 MET-h/day) had an estimated 3.4 cm(3) (95% confidence interval, 2.3-4.7) lower absolute dense volume. The inverse association was seen for any type of physical activity among women with <3.0% TC 10-year risk, but only for total and vigorous activities among women with 3.0-4.9% TC risk, and only for vigorous activity among women with ≥5.0% TC risk. The association between total activity and absolute dense volume was modified by the TC breast cancer risk (P interaction = 0.05). As anticipated, high physical activity was also associated with lower non-dense volume. No consistent association was found between physical activity and percent dense volume.
CONCLUSIONS
Our results suggest that physical activity may decrease breast cancer risk through reducing mammographic density, and that the physical activity needed to reduce mammographic density may depend on background risk of breast cancer.
引言
高体力活动已被证明可降低患乳腺癌的风险，其潜在机制可能也会降低乳腺X线密度。我们检验了这样一个假设，即根据泰勒-库齐克预测模型得出的未来10年患乳腺癌的风险会影响体力活动与乳腺X线密度之间的关联。
方法
我们对38913名年龄在40 - 74岁的瑞典女性进行了一项基于人群的横断面研究。使用经过验证的网络问卷Active-Q评估体力活动情况，并通过全自动容积法Volpara测量乳腺X线密度。使用泰勒-库齐克（TC）预测模型估计患乳腺癌的10年风险。进行线性回归分析以评估体力活动与容积乳腺X线密度之间的关联以及与TC乳腺癌风险的潜在相互作用。
结果
总体而言，高体力活动与较低的绝对致密体积相关。与总活动水平最低（每天<40代谢当量小时[MET - h]）的女性相比，总活动水平最高（≥50 MET - h/天）的女性估计绝对致密体积低3.4立方厘米（95%置信区间，2.3 - 4.7）。在TC 10年风险<3.0%的女性中，任何类型的体力活动都呈现出负相关，但在TC风险为3.0 - 4.9%的女性中，仅总活动和剧烈活动呈现负相关，而在TC风险≥5.0%的女性中，仅剧烈活动呈现负相关。总活动与绝对致密体积之间的关联因TC乳腺癌风险而改变（P相互作用 = 0.05）。正如预期的那样，高体力活动也与较低的非致密体积相关。未发现体力活动与致密体积百分比之间存在一致的关联。
结论
我们的结果表明，体力活动可能通过降低乳腺X线密度来降低乳腺癌风险，并且降低乳腺X线密度所需的体力活动可能取决于乳腺癌的背景风险。
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