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卵巢切除术后乳腺癌发病率:一项前瞻性丹麦队列研究。

Breast cancer rate after oophorectomy: A Prospective Danish Cohort Study.

机构信息

Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

出版信息

Int J Cancer. 2021 Aug 1;149(3):585-593. doi: 10.1002/ijc.33563. Epub 2021 Apr 2.

Abstract

The association between oophorectomy and risk of breast cancer in the general population is uncertain. The aim of our study was to determine the breast cancer rate in women from the general population after oophorectomy (performed before/after menopause), and whether this varies by use of hormone replacement therapy (HRT), hysterectomy, body mass index (BMI) and shift work. The study included 24 409 female nurses (aged ≥45 years) participating in the Danish Nurse Cohort. Nurses were followed from cohort entry until date of breast cancer, death, emigration or end of follow-up at 31 December 2018, whichever came first. Poisson regression with log-transformed person-years as the offset examined the association between oophorectomy and breast cancer (all ages and stratified by menopausal status at time of oophorectomy). The potential modifying effect of HRT use, hysterectomy, BMI and shift work on the associations was estimated. During 502 463 person-years of follow-up, 1975 (8.1%) nurses were diagnosed with breast cancer. Bilateral oophorectomy was associated with a reduced breast cancer rate compared to nurses with preserved ovaries, adjusted rate ratio (95% confidence interval): 0.79 (0.64; 0.99). Similar associations (magnitude and direction) were detected for unilateral oophorectomy and when stratifying according to menopausal status at time of oophorectomy, but without statistical significance. Unilateral and bilateral oophorectomy is associated with a reduced breast cancer rate in women from the general population. This association is not modified by use of HRT, hysterectomy, BMI or shift work.

摘要

卵巢切除术与普通人群乳腺癌风险的关系尚不确定。我们的研究目的是确定接受卵巢切除术(绝经前/后)的普通人群女性的乳腺癌发病率,以及这种发病率是否因激素替代疗法(HRT)、子宫切除术、体重指数(BMI)和轮班工作而有所不同。该研究纳入了 24409 名参与丹麦护士队列的女性护士(年龄≥45 岁)。护士从队列入组开始随访,直至乳腺癌发病、死亡、移民或 2018 年 12 月 31 日随访结束(以先发生者为准)。使用对数转换的人年作为偏移量的泊松回归分析了卵巢切除术与乳腺癌(所有年龄组和按卵巢切除术时的绝经状态分层)之间的关联。估计了 HRT 使用、子宫切除术、BMI 和轮班工作对这些关联的潜在修饰作用。在 502463 人年的随访期间,有 1975 名(8.1%)护士被诊断患有乳腺癌。与保留卵巢的护士相比,双侧卵巢切除术与乳腺癌发病率降低相关,调整后的比率比(95%置信区间):0.79(0.64;0.99)。单侧卵巢切除术和按卵巢切除术时的绝经状态分层时也观察到类似的关联(大小和方向),但无统计学意义。单侧和双侧卵巢切除术与普通人群女性的乳腺癌发病率降低相关。这种关联不受 HRT 使用、子宫切除术、BMI 或轮班工作的影响。

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