Toktaş Osman, Elasan Sadi, İliklerden Ümit Haluk, Erten Remzi, Karayil Ali Rıza, Özdemir Abdulselam, Aslan Fırat, Binici Serhat, Özalp İbrahim, Şentürk Enes
Department of General Surgery, Van Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.
Department of Biostatistics, Van Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.
Eur J Breast Health. 2020 Dec 24;17(1):15-20. doi: 10.4274/ejbh.2020.5713. eCollection 2021 Jan.
The prognosis of breast cancer (BC) is determined directly based on the stage of disease at the time of diagnosis. Proliferative breast lesions (PBLs) are an important risk factor for BC development. The risk of developing BC varies according to the presence of extent of proliferation in the breast lesions. We aimed to investigate the effect of BC risk factors on the PBLs in this study.
Patients who visited the surgical clinic of the university during the past 6 years who presented with PBLs with or without atypia by fine/core needle aspiration biopsy were included in this study. The relationship between PBLs and BC risk factors such as the age, mass size, Body Mass index (BMI), smoking, sports activity, BC family history, the use of hormone replacement therapy, number of pregnancies, and the duration of breastfeeding were compared.
A total of 74 (96.1%) of all patients were women and three were men. The median age of the patients was 38 (range: 19-74) years; the cut-off value of age was 35.5 years. The mean age of patients with PBL-with atypia (PBL-WA) was higher (p=0.005) in the malignant group based on the final pathology and radiological imaging features (for both, p<0.001). The mean size of the mass was large at 2.53±1.33 (1-6) cm; and the cut-off value of the tumor size was 2.5 cm. The mean size was greater in the PBL-WA patients (p=0.171) in the malignant group based on the final pathology and radiological characteristic (respectively, p=0.004 and p=0.016). The mean BMI was 26.8±4.4 kg/m (18.8-35.1) and the cut-off value was 25.4 kg/m. BMI was greater in the PBL-WA group and in the malignant group based on the final pathology (respectively, p=0.002 and p=0.001). Smoking was positive in 66.2% (n=51) of the patients, and it was high in the PBL-WA patients (p=0.001). The percentage of patients with no sports activity was 63.6% (n=49), while it was 20.8% (n=16) for those with once a week sports activity and 15.6% (n=12) for those with twice a week activity. There was family history of BC in 16.9% (n=13) of all patients. The number of positive cases of family history of BC was greater in the malignant group (p=0.001). Hormone replacement therapy was recorded in 11.7% (n=9) of the patients. The mean numbers of pregnancies (2.1±2.4) and breastfeeding duration (32.5±37.4 months) were low in the benign groups due to the relatively lower average age of the patients.
Based on our analysis, age is an extremely important aspect for assessing PBLs. The age of the patient was statistically significantly greater in the patients with malignant lesions in all groups. The factors lesion size, BMI, smoking habit, and BC family history were also more frequent in the malignant groups. The rate of sports activity was lower in the malignant groups. Thus, it is necessary to evaluate patients individually when evaluating PBLs. It is recommended to evaluate PBLs together with BC risk factors for the better understanding.
乳腺癌(BC)的预后直接取决于诊断时的疾病分期。乳腺增生性病变(PBLs)是BC发生的重要危险因素。BC发生风险因乳腺病变中增殖程度的不同而有所差异。本研究旨在探讨BC危险因素对PBLs的影响。
本研究纳入了过去6年期间到大学外科门诊就诊的患者,这些患者经细针/粗针穿刺活检显示有或无非典型性的PBLs。比较了PBLs与BC危险因素之间的关系,如年龄、肿块大小、体重指数(BMI)、吸烟、体育活动、BC家族史、激素替代疗法的使用、妊娠次数和母乳喂养持续时间。
所有患者中共有74名(96.1%)为女性,3名男性。患者的中位年龄为38岁(范围:19 - 74岁);年龄的临界值为35.5岁。根据最终病理和影像学特征,非典型性PBL(PBL - WA)患者在恶性组中的平均年龄更高(p = 0.005)(两者均p < 0.001)。肿块的平均大小为2.53±1.33(1 - 6)cm;肿瘤大小的临界值为2.5 cm。根据最终病理和影像学特征,恶性组中PBL - WA患者的平均大小更大(p = 0.171)(分别为p = 0.004和p = 0.016)。平均BMI为26.8±4.4 kg/m²(18.8 - 35.1),临界值为25.4 kg/m²。基于最终病理,PBL - WA组和恶性组的BMI更高(分别为p = 0.002和p = 0.001)。66.2%(n = 51)的患者吸烟呈阳性,PBL - WA患者中吸烟率较高(p = 0.001)。无体育活动的患者比例为63.6%(n = 49),每周进行一次体育活动的患者比例为20.8%(n = 16),每周进行两次体育活动的患者比例为15.6%(n = 12)。所有患者中有16.9%(n = 13)有BC家族史。恶性组中BC家族史阳性病例数更多(p = 0.001)。11.7%(n = 9)的患者记录了激素替代疗法的使用情况。由于患者平均年龄相对较低,良性组的平均妊娠次数(2.1±2.4)和母乳喂养持续时间(32.5±37.4个月)较低。
基于我们的分析,年龄是评估PBLs的一个极其重要的方面。在所有组中,恶性病变患者的年龄在统计学上显著更高。病变大小、BMI、吸烟习惯和BC家族史这些因素在恶性组中也更常见。恶性组的体育活动率较低。因此,在评估PBLs时需要对患者进行个体评估。建议将PBLs与BC危险因素一起评估,以便更好地理解。