Key Laboratory of Breast Cancer Prevention and Therapy in Ministry of Education, Key Laboratory of Molecular Cancer Epidemiology of Tianjin, Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China.
Key Laboratory of Breast Cancer Prevention and Therapy in Ministry of Education, Department of Cancer Biobank, National Clinical Research Centre of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China.
Cancer Med. 2019 Apr;8(4):1882-1892. doi: 10.1002/cam4.2012. Epub 2019 Feb 14.
Epidemiological studies have a clear definition of the risk factors for breast cancer. However, it is unknown whether the distribution of these factors differs among breast cancer subtypes. We conducted a hospital-based case-only study consisting of 8067 breast cancer patients basing on the Tianjin Cohort of Breast Cancer Cases. Major breast cancer subtypes including luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched and basal-like were defined by estrogen receptor, progesterone receptor, HER2, and Ki-67 status. Variables including demographic characteristics, reproductive factors, lifestyle habits, imaging examination, and clinicopathologic data were collected for patients. Chi-square test and one-way analysis of variance were used to compare the distributions of variables among the four breast cancer subtypes. Multivariate logistic regression was used to estimate the odds ratios and associated 95% confidence intervals where luminal A patients served as the reference group. Overall, more commonality rather than heterogeneity on the distributions of factors was found between the four molecular subtypes of breast cancer. The proportion of overweight and obesity were lower in HER2-enriched subtype. Women with age at menarche ≤13 years were more likely to be found in basal-like subtype. Postmenopausal women were more frequent in HER2-enriched and basal-like subtypes. Women with benign breast disease and higher breast density were more common in HER2-enriched subtype. Risk factor scoring showed that total risk scores were similar among the four subtypes. HER2-enriched and basal-like subtypes were more frequently diagnosed with large tumors. Calcification was more likely to be found in luminal B and HER2-enriched subtypes, whereas less distributed in basal-like subtype. Most of the breast cancer risk factors were similarly distributed among the four major breast cancer subtypes; commonality is predominant.
流行病学研究对乳腺癌的危险因素有明确的定义。然而，这些因素在不同乳腺癌亚型中的分布是否不同尚不清楚。我们基于天津乳腺癌病例队列进行了一项基于医院的病例对照研究，共纳入 8067 例乳腺癌患者。主要乳腺癌亚型包括 luminal A、luminal B、人表皮生长因子受体 2（HER2）富集型和基底样型，根据雌激素受体、孕激素受体、HER2 和 Ki-67 状态定义。为患者收集了包括人口统计学特征、生殖因素、生活方式习惯、影像学检查和临床病理数据在内的变量。采用卡方检验和单因素方差分析比较了四个乳腺癌亚型之间变量的分布情况。采用多因素 logistic 回归估计比值比及其 95%置信区间，以 luminal A 患者为参照组。总体而言，在四个分子亚型的乳腺癌中，发现因素分布的共性多于异质性。HER2 富集型的超重和肥胖比例较低。初潮年龄≤13 岁的女性更有可能被归类为基底样型。绝经后女性更常见于 HER2 富集型和基底样型。患有良性乳腺疾病和乳腺密度较高的女性更常见于 HER2 富集型。风险因素评分显示，四个亚型的总风险评分相似。HER2 富集型和基底样型更常被诊断为大肿瘤。钙化为 luminal B 和 HER2 富集型更常见，而基底样型较少见。大多数乳腺癌危险因素在四个主要乳腺癌亚型中的分布相似；共性占主导地位。
