生活方式、行为和饮食风险因素与乳腺癌高危女性的乳腺钼靶密度的关系。
Lifestyle, Behavioral, and Dietary Risk Factors in Relation to Mammographic Breast Density in Women at High Risk for Breast Cancer.
机构信息
Department of Surgery, Larner College of Medicine at the University of Vermont, Burlington, Vermont.
Department of Biochemistry, Larner College of Medicine at the University of Vermont, Burlington, Vermont.
出版信息
Cancer Epidemiol Biomarkers Prev. 2021 May;30(5):936-944. doi: 10.1158/1055-9965.EPI-20-1567. Epub 2021 Feb 22.
BACKGROUND
Women at high risk for breast cancer due to genetics or risk factor profiles are counseled to adopt lifestyle, behavioral, and dietary changes to help reduce their risk. These recommendations are based on studies of women at average risk, so their effectiveness in high-risk women is unclear.
METHODS
We evaluated the impact of physical activity, smoking, alcohol consumption, and intake of folate and carotenoids on mammographic breast density-a proxy for breast cancer risk-among 387 high-risk women. Exposures were self-reported on questionnaires. Breast dense area, nondense area, and percent dense area were measured from screening mammograms with Library for Breast Radiodensity Assessment software. Cross-sectional associations were estimated with multivariable quantile regression models.
RESULTS
After adjusting for age, adiposity, reproductive history, and use of postmenopausal hormones, no breast density measure was associated with physical activity level, smoking status, alcohol consumption, or estimated intake of folate, alpha-carotene, beta-carotene, lutein/zeaxanthin, and beta-cryptoxanthin. Lycopene intake was associated with lower dense area when comparing the highest and lowest intake categories (adjusted difference in median = -14 cm, 95% confidence interval: -29 to 1.3 cm). This association may be explained by incomplete adjustment for adiposity.
CONCLUSIONS
Recommended lifestyle, behavioral, and dietary changes to mitigate personal risk of breast cancer do not substantially impact mammographic breast density measures.
IMPACT
Alternative strategies, such as increased uptake of chemoprevention, may better serve risk reduction efforts in women at high risk for breast cancer.
背景
由于遗传或风险因素，某些女性患乳腺癌的风险较高，因此这些女性被建议改变生活方式、行为和饮食习惯，以降低风险。这些建议基于对平均风险女性的研究，因此其在高风险女性中的有效性尚不清楚。
方法
我们评估了体育活动、吸烟、饮酒以及叶酸和类胡萝卜素摄入对 387 名高危女性乳房 X 光片乳腺密度（乳腺癌风险的替代指标）的影响。通过问卷调查收集暴露信息。使用 Library for Breast Radiodensity Assessment 软件从筛查性乳房 X 光片中测量乳腺致密区、非致密区和致密区百分比。采用多变量分位数回归模型估计了横断面关联。
结果
调整年龄、肥胖程度、生殖史和绝经后激素使用后，没有任何乳腺密度指标与体育活动水平、吸烟状况、饮酒量或叶酸、α-胡萝卜素、β-胡萝卜素、叶黄素/玉米黄质、β-隐黄质的估计摄入量相关。与最低摄入量类别相比，番茄红素摄入量最高和最低的两个类别之间的致密区面积差异较小（调整后的中位数差异=-14cm，95%置信区间：-29 至 1.3cm）。这种关联可能是由于对肥胖程度的调整不充分所致。
结论
建议的减轻个人乳腺癌风险的生活方式、行为和饮食改变对乳房 X 光片乳腺密度测量指标没有显著影响。
影响
在高风险乳腺癌女性中，可能需要采用其他策略，如增加化学预防药物的使用，以更好地进行风险降低工作。
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