Slone Epidemiology Center at Boston University, Boscton, MA, USA.
Slone Epidemiology Center at Boston University, Boscton, MA, USA.
Breast. 2020 Feb;49:108-114. doi: 10.1016/j.breast.2019.10.009. Epub 2019 Nov 6.
Compared to U.S. white women, African American women are more likely to die from ductal carcinoma in situ (DCIS). Elucidation of risk factors for DCIS in African American women may provide opportunities for risk reduction.
We used data from three epidemiologic studies in the African American Breast Cancer Epidemiology and Risk Consortium to study risk factors for estrogen receptor (ER) positive DCIS (488 cases; 13,830 controls). Results were compared to associations observed for ER+ invasive breast cancer (n = 2,099).
First degree family history of breast cancer was associated with increased risk of ER+ DCIS [odds ratio (OR): 1.69, 95% confidence interval (CI): 1.31, 2.17]. Oral contraceptive use within the past 10 years (vs. never) was also associated with increased risk (OR: 1.43, 95%CI: 1.03, 1.97), as was late age at first birth (≥25 years vs. <20 years) (OR: 1.26, 95%CI: 0.96, 1.67). Risk was reduced in women with older age at menarche (≥15 years vs. <11 years) (OR: 0.62, 95%CI: 0.42, 0.93) and higher body mass index (BMI) in early adulthood (≥25 vs. <20 kg/m at age 18 or 21) (OR: 0.75, 95%CI: 0.55, 1.01). There was a positive association of recent BMI with risk in postmenopausal women only. In general, associations of risk factors for ER+ DCIS were similar in magnitude and direction to those for invasive ER+ breast cancer.
Our findings suggest that most risk factors for invasive ER+ breast cancer are also associated with increased risk of ER+ DCIS among African American women.
与美国白人女性相比,非裔美国女性死于导管原位癌(DCIS)的可能性更大。阐明非裔美国女性 DCIS 的风险因素可能为降低风险提供机会。
我们使用非洲裔美国乳腺癌流行病学和风险联合会的三项流行病学研究的数据来研究雌激素受体(ER)阳性 DCIS(488 例;13830 例对照)的危险因素。结果与 ER+浸润性乳腺癌(n=2099)的关联进行了比较。
一级亲属乳腺癌病史与 ER+DCIS 风险增加相关[比值比(OR):1.69,95%置信区间(CI):1.31,2.17]。最近 10 年内(与从未使用过相比)使用口服避孕药也与风险增加相关(OR:1.43,95%CI:1.03,1.97),初产年龄较晚(≥25 岁与<20 岁)(OR:1.26,95%CI:0.96,1.67)也是如此。初潮年龄较大(≥15 岁与<11 岁)的女性风险降低(OR:0.62,95%CI:0.42,0.93),成年早期(18 岁或 21 岁时≥25 与<20kg/m)的体重指数(BMI)较高(OR:0.75,95%CI:0.55,1.01)。绝经后妇女的近期 BMI 与风险呈正相关。一般来说,ER+DCIS 的危险因素与 ER+浸润性乳腺癌的风险因素在大小和方向上相似。
我们的研究结果表明,侵袭性 ER+乳腺癌的大多数危险因素也与非裔美国女性 ER+DCIS 风险增加相关。