Bhettani Mehreen K, Rehman Mubarik, Altaf Humera N, Ahmed Syed M, Tahir Ahmad A, Khan Muhammad S, Imran Tanzeel
General Surgery, Royal Oldham Hospital, Manchester, GBR.
General Surgery, Shifa College of Medicine, Islamabad, PAK.
Cureus. 2019 Jul 23;11(7):e5219. doi: 10.7759/cureus.5219.
Introduction Among all benign conditions, the fibroadenoma is the most common lesion worldwide as well as in Pakistan. Clinicians often face the dilemma of whether to remove the mass or to monitor it by means of periodic follow-up examinations. Although the removal of these lesions is a definitive solution, surgery may involve unnecessary excision of benign lesions and unbecoming cosmesis. Body mass index (BMI) is a known risk factor for the development of breast cancer.However, the relationship between BMI and benign breast diseases is still unclear. Some studies showed that increased BMI is a risk factor for benign breast diseases; however, a large number of studies showed that a decrease in BMI is the risk factor for benign breast diseases. Material and methods This was a descriptive cross-sectional study conducted at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. All patients fulfilling inclusion criteria were assessed in the breast clinic of PIMS. A final diagnosis of fibroadenoma was made after a triple assessment. Weight in kilograms and height in meters were measured. All the information was recorded in a specifically designed proforma accordingly by the postgraduate trainee. BMI was calculated by the formula: BMI=Weight in kgs/height in meters. Other variables that were noted include patients' age, gender, contact number, and hospital visit. The data were analyzed using SPSS version 21 (IBM Corp., Armonk, NY, US). Results The BMI of study patients was 21.8 ± 1.3, ranging from 19 to 24.9. Out of 300 patients presenting with benign breast disease, 60 (20%) had a fibroadenoma while 240 (80%) had other benign breast diseases. Out of 136 patients with high BMI, 42 (30.8%) had a fibroadenoma while out of 74 patients with low BMI, eight (10.8%) had a fibroadenoma; however, out of 90 patients with normal BMI, 10 (11.1%) had a fibroadenoma. Our study population showed an increased risk of fibroadenoma formation in the adolescent age group with an OR value of 8.54 (CI 4.38-16.63, P<0.001). There were also additional statistical correlations between higher BMI and the site of the lesion being the upper outer quadrant of the breast (t= 4.326 P<0.01). There was no significant correlation of BMI with size and increased number of lesions (P=0.280 and P=0.175). Conclusion High BMI seems to be a substantial risk factor for the development of a fibroadenoma, particularly in young adolescent females.
引言
在所有良性疾病中,纤维腺瘤是全球以及巴基斯坦最常见的病变。临床医生常常面临两难抉择,即是否切除肿块还是通过定期随访检查来监测它。虽然切除这些病变是一种确定性的解决方案,但手术可能涉及对良性病变的不必要切除以及不理想的美容效果。体重指数(BMI)是已知的乳腺癌发病风险因素。然而,BMI与良性乳腺疾病之间的关系仍不清楚。一些研究表明,BMI升高是良性乳腺疾病的风险因素;然而,大量研究表明,BMI降低是良性乳腺疾病的风险因素。
材料与方法
这是一项在巴基斯坦伊斯兰堡沙希德·佐勒菲卡尔·阿里·布托医科大学巴基斯坦医学科学研究所普通外科进行的描述性横断面研究。所有符合纳入标准的患者在巴基斯坦医学科学研究所的乳腺诊所进行评估。经过三重评估后做出纤维腺瘤的最终诊断。测量体重(千克)和身高(米)。所有信息由研究生实习生相应地记录在专门设计的表格中。BMI通过公式计算:BMI = 体重(千克)/身高(米)。记录的其他变量包括患者的年龄、性别、联系电话和就诊医院。使用SPSS 21版(美国纽约州阿蒙克市IBM公司)对数据进行分析。
结果
研究患者的BMI为21.8±1.3,范围在19至24.9之间。在300例患有良性乳腺疾病的患者中,60例(20%)患有纤维腺瘤,而240例(80%)患有其他良性乳腺疾病。在136例BMI较高的患者中,42例(30.8%)患有纤维腺瘤,而在74例BMI较低的患者中,8例(10.8%)患有纤维腺瘤;然而,在90例BMI正常的患者中,10例(11.1%)患有纤维腺瘤。我们的研究人群显示青少年年龄组患纤维腺瘤的风险增加,OR值为8.54(CI 4.38 - 16.63,P < 0.001)。BMI较高与病变位于乳腺外上象限之间也存在其他统计学相关性(t = 4.326,P < 0.01)。BMI与病变大小和病变数量增加无显著相关性(P = 0.280和P = 0.175)。
结论
高BMI似乎是纤维腺瘤发生的一个重要风险因素,尤其是在年轻的青少年女性中。