Romieu I Isabelle, Amadou A, Chajes V
Center of Research on Population Health, National Institute of Public Health, Cuernavaca, Mor., Mexico.
Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA.
Rev Invest Clin. 2017 Jul-Aug;69(4):193-203. doi: 10.24875/ric.17002263.
The incidence of breast cancer (BC) is rising worldwide, with an increase in aggressive neoplasias in young women. Traditionally, BC in young women has been thought to be etiologically driven, primarily by genetic/hereditary factors. However, these factors explain only a small proportion of BCs, pointing to a role of the environment. Suspected factors responsible for this increase include lifestyle changes, notably alcohol consumption, diet with high intake of refined carbohydrates and saturated fat and low intake of polyunsaturated fatty acids (PUFA), fiber and vitamins (such as folate, vitamin D, and carotenoids), low physical activity, and body fatness, all of which may act from childhood and adolescent years through adulthood. Despite limited data on BC in young women, evidence points to the importance of a healthy lifestyle, including high intake of vegetables, fruits, legumes, fish, and poultry, low intake of sugar and fat, daily physical activity, low alcohol consumption, steady weight, and breastfeeding in preventing BC in young women. Preventive efforts should begin in early life to provide important benefits much later in life by shifting the long-term trajectory of risk accumulation. Data from Latin America and developing regions are still sparse. There is a need to harmonize studies in a global effort to fight the rise of BC incidence in low- and middle-income countries, where the nutritional transition is occurring rapidly. The stratification of BC by specific tumor characteristics needs to be considered since risk factors may be more particularly associated with the promotion of, or protection from, a defined type of BC.
全球乳腺癌（BC）的发病率正在上升，年轻女性中侵袭性肿瘤的数量也在增加。传统上，年轻女性的乳腺癌一直被认为主要由遗传/遗传因素导致发病。然而，这些因素仅能解释一小部分乳腺癌病例，这表明环境因素也发挥了作用。导致这一增长的可疑因素包括生活方式的改变，特别是饮酒、高精制碳水化合物和饱和脂肪摄入以及多不饱和脂肪酸（PUFA）、纤维和维生素（如叶酸、维生素D和类胡萝卜素）摄入不足的饮食、缺乏体育锻炼以及肥胖，所有这些因素可能从儿童期和青少年期一直持续到成年期都产生影响。尽管关于年轻女性乳腺癌的数据有限，但证据表明健康的生活方式很重要，包括大量摄入蔬菜、水果、豆类、鱼类和家禽，低糖和低脂肪摄入、日常体育锻炼、低酒精摄入、体重稳定以及母乳喂养，这些对于预防年轻女性患乳腺癌都很重要。预防措施应在生命早期就开始，通过改变风险积累的长期轨迹，在生命后期带来重要益处。拉丁美洲和发展中地区的数据仍然稀少。有必要在全球范围内协调各项研究，以应对低收入和中等收入国家乳腺癌发病率上升的问题，这些国家正在迅速经历营养转型。由于风险因素可能与特定类型乳腺癌的发生或预防更为特别相关，因此需要考虑根据特定肿瘤特征对乳腺癌进行分层。
