Cancer Registry of Norway, Oslo, Norway.
Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Cancer Epidemiol Biomarkers Prev. 2017 Dec;26(12):1736-1744. doi: 10.1158/1055-9965.EPI-17-0611. Epub 2017 Sep 6.
To what extent alcohol, smoking, and physical activity are associated with the various subtypes of breast cancer is not clear. We took advantage of a large population-based screening cohort to determine whether these risk factors also increase the risk of the poor prognosis subtypes. We conducted a matched case-control study nested within the Norwegian Breast Cancer Screening Program during 2006-2014. A total of 4,402 breast cancer cases with risk factor and receptor data were identified. Five controls were matched to each case on year of birth and year of screening. Conditional logistic regression was used to estimate ORs of breast cancer subtypes adjusted for potential confounders. There were 2,761 luminal A-like, 709 luminal B-like HER2-negative, 367 luminal B-like HER2-positive, 204 HER2-positive, and 361 triple-negative cancers. Current alcohol consumption was associated with breast cancer risk overall [OR 1.26; 95% confidence interval (CI), 1.09-1.45] comparing 6+ glasses a week to never drinkers. However, this risk increase was found only for luminal A-like breast cancer. Smoking 20+ cigarettes a day was associated with an OR of 1.41 (95% CI, 1.06-1.89) overall, with significant trends for luminal A-like and luminal B-like HER2-negative cancer. Current physical activity (4+ hours/week compared with none) was associated with 15% decreased risk of luminal A-like cancer, but not clearly with other subtypes. In this large study, alcohol, smoking, and physical activity were predominantly associated with luminal A-like breast cancer. Alcohol, smoking, and physical activity were associated with luminal A-like breast cancer subtype. .
酒精、吸烟和体育活动与各种乳腺癌亚型的关联程度尚不清楚。我们利用一个大型基于人群的筛查队列来确定这些危险因素是否也会增加预后不良亚型的风险。我们在 2006 年至 2014 年期间进行了一项嵌套在挪威乳腺癌筛查计划中的病例对照研究。共确定了 4402 例具有危险因素和受体数据的乳腺癌病例。每个病例都与出生年份和筛查年份匹配了 5 个对照。使用条件逻辑回归来估计调整潜在混杂因素后的乳腺癌亚型的 OR。其中 2761 例为 luminal A 样，709 例为 luminal B 样 HER2-阴性，367 例为 luminal B 样 HER2-阳性，204 例为 HER2 阳性，361 例为三阴性。目前的饮酒与乳腺癌总体风险相关[OR 1.26；95%置信区间（CI），1.09-1.45]，每周饮酒 6 杯以上与从不饮酒者相比。然而，这种风险增加仅见于 luminal A 样乳腺癌。每天吸烟 20 支以上与整体的 OR 为 1.41（95%CI，1.06-1.89），luminal A 样和 luminal B 样 HER2-阴性癌症存在显著趋势。目前的体育活动（每周 4 小时以上与无活动相比）与 luminal A 样乳腺癌风险降低 15%相关，但与其他亚型无明显关联。在这项大型研究中，酒精、吸烟和体育活动主要与 luminal A 样乳腺癌相关。酒精、吸烟和体育活动与 luminal A 样乳腺癌亚型相关。
