Ellingjord-Dale Merete, Vos Linda, Vik Hjerkind Kirsti, Hjartåker Anette, Russnes Hege G, Tretli Steinar, Hofvind Solveig, Dos-Santos-Silva Isabel, Ursin Giske
Department of research, Cancer Registry of Norway, Oslo, Norway.
Department of nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
JNCI Cancer Spectr. 2018 Jul 19;2(3):pky030. doi: 10.1093/jncics/pky030. eCollection 2018 Jul.
Lifestyle factors are associated with overall breast cancer risk, but less is known about their associations, alone or jointly, with risk of specific breast cancer subtypes.
We conducted a case-control subjects study nested within a cohort of women who participated in the Norwegian Breast Cancer Screening Program during 2006-2014 to examine associations between risky lifestyle factors and breast cancer risk. In all, 4402 breast cancer cases subjects with information on risk factors and hormone receptor status were identified. Conditional logistic regression was used to estimate odds ratios (ORs), with 95% confidence intervals (CIs), in relation to five risky lifestyle factors: body mass index (BMI) of 25 kg/m² or greater, three or more glasses of alcoholic beverages per week, ever smoking, fewer than four hours of physical activity per week, and ever use of menopausal hormone therapy. Analyses were adjusted for education, age at menarche, number of pregnancies, and menopausal status. All statistical tests were two-sided.
Compared with women with no risky lifestyle behaviors, those with five had 85% (OR = 1.85, 95% CI = 1.42 to 2.42, < .0001) increased risk of breast cancer overall. This association was limited to luminal A-like (OR = 2.20, 95% CI = 1.55 to 3.12, < .0001) and luminal B-like human epidermal growth factor receptor 2 (HER2)-positive (OR = 1.66, 95% CI = 0.61 to 4.54, < .004) subtypes. Number of risky lifestyle factors was not associated with increased risk of luminal B-like HER2-negative, HER2-positive, or triple-negative subtypes ( > .18 for all).
Number of risky lifestyle factors was positively associated with increased risk for luminal A-like and luminal B-like HER2-positive breast cancer.
生活方式因素与总体乳腺癌风险相关，但对于它们单独或共同与特定乳腺癌亚型风险之间的关联，人们了解较少。
我们在一组于2006年至2014年期间参与挪威乳腺癌筛查项目的女性队列中开展了一项病例对照研究，以探究危险生活方式因素与乳腺癌风险之间的关联。总共确定了4402例有危险因素和激素受体状态信息的乳腺癌病例。使用条件逻辑回归来估计与五种危险生活方式因素相关的比值比（OR）及其95%置信区间（CI），这五种因素分别为：体重指数（BMI）达到或超过25kg/m²、每周饮用三杯或更多杯酒精饮料、曾经吸烟、每周体育活动少于四小时以及曾经使用绝经激素治疗。分析针对教育程度、初潮年龄、怀孕次数和绝经状态进行了调整。所有统计检验均为双侧检验。
与没有危险生活方式行为的女性相比，有五种危险生活方式行为的女性总体患乳腺癌的风险增加了85%（OR = 1.85，95%CI = 1.42至2.42，P <.0001）。这种关联仅限于管腔A型样（OR = 2.20，95%CI = 1.55至3.12，P <.0001）和管腔B型样人表皮生长因子受体2（HER2）阳性（OR = 1.66，95%CI = 0.61至4.54，P <.004）亚型。危险生活方式因素的数量与管腔B型样HER2阴性、HER2阳性或三阴性亚型风险增加无关（所有P均>.18）。
危险生活方式因素的数量与管腔A型样和管腔B型样HER2阳性乳腺癌风险增加呈正相关。
