比较韩国女性的乳腺密度和临床因素与导管原位癌和浸润性导管乳腺癌的关联。
Comparison of the association of mammographic density and clinical factors with ductal carcinoma in situ versus invasive ductal breast cancer in Korean women.
机构信息
Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
出版信息
BMC Cancer. 2017 Dec 5;17(1):821. doi: 10.1186/s12885-017-3841-0.
BACKGROUND
In spite of the increasing incidence of in situ breast cancer, the information about the risk factors of in situ breast cancer (DCIS) is scarce as compared to the information available for invasive ductal breast cancer (IDC), with inconsistent findings regarding the difference in risk factors between DCIS and IDC.
METHODS
We enrolled 472 women with IDC and 90 women with DCIS and 1088 controls matching for age and menopausal status. Information on risk factors was collected through self-administered questionnaire. Percent mammographic dense area (PDA), absolute mammographic dense area (ADA), and nondense area were assessed using a computer-assisted thresholding technique. Odds ratio (OR) and 95% confidence intervals (CI) were estimated by conditional logistic regression model with adjustment for covariates.
RESULTS
Later age at menarche and regular physical exercise were associated with decreased risk of IDC, whereas alcohol consumption, previous benign breast disease, and family history of breast cancer were associated with increased risk of IDC. For DCIS, previous benign breast disease and alcohol consumption were associated with the increased risk, and regular physical exercise was associated with decreased risk. Increase of ADA by 1-quartile level and PDA increase by 10% were associated with 1.10 (95% CI: 1.01, 1.21) and 1.10 (95% CI: 1.01, 1.19) times greater risk of IDC, respectively. The increase of ADA by 1-quartile level and PDA increase by 10% were associated with 1.17 (95% CI: 0.91, 1.50) times and 1.11 (95% CI:0.90,1.37) times greater risk of DCIS, respectively, but the associations were not statistically significant. There was no significant difference in the association with risk factors and mammographic density measures between IDC and DCIS (P > 0.1).
CONCLUSIONS
Differential associations of DCIS with mammographic density and risk factors as compared with the associations of IDC were not evident. This finding suggests that IDC and DCIS develop through the shared causal pathways.
背景
尽管原位乳腺癌（DCIS）的发病率不断上升，但与浸润性导管乳腺癌（IDC）相比，有关其危险因素的信息仍然匮乏，且关于 DCIS 和 IDC 危险因素之间差异的研究结果并不一致。
方法
我们纳入了 472 名 IDC 患者、90 名 DCIS 患者和 1088 名年龄和绝经状态匹配的对照者。通过自填式问卷收集危险因素信息。采用计算机辅助阈值技术评估百分比乳腺密度面积（PDA）、绝对乳腺密度面积（ADA）和非密度面积。采用条件 logistic 回归模型，在调整协变量后，估计比值比（OR）和 95%置信区间（CI）。
结果
初潮年龄较晚和定期体育锻炼与 IDC 发病风险降低相关，而饮酒、既往良性乳腺疾病和乳腺癌家族史与 IDC 发病风险增加相关。对于 DCIS，既往良性乳腺疾病和饮酒与发病风险增加相关，而定期体育锻炼与发病风险降低相关。ADA 增加 1 四分位间距和 PDA 增加 10%与 IDC 发病风险分别增加 1.10（95%CI：1.01，1.21）和 1.10（95%CI：1.01，1.19）相关。ADA 增加 1 四分位间距和 PDA 增加 10%与 DCIS 发病风险分别增加 1.17（95%CI：0.91，1.50）和 1.11（95%CI：0.90，1.37）相关，但差异无统计学意义。在 IDC 和 DCIS 之间，危险因素和乳腺密度测量值与发病风险的关联无显著差异（P＞0.1）。
结论
DCIS 与 IDC 相比，其与乳腺密度和危险因素的关联存在差异并不明显。这一发现表明，IDC 和 DCIS 通过共同的因果途径发展。
Zotero 插件