Cancer Registry of Norway, Oslo, Norway.
Department of Mathematics, University of Oslo, Oslo, Norway.
Int J Cancer. 2021 Sep 15;149(6):1247-1256. doi: 10.1002/ijc.33680. Epub 2021 May 22.
Physical inactivity, high postmenopausal body mass index, alcohol consumption and use of menopausal hormone therapy are established risk factors for breast cancer. Less is known about whether these factors influence the risk of progression of benign and premalignant breast lesions to invasive breast cancer. This registry-based cohort study was based on women with a precancerous lesion who were followed for breast cancer. The cohort consisted of 11 270 women with a benign lesion, 972 women with hyperplasia with atypia and 2379 women with carcinoma in situ diagnosed and treated after participation in BreastScreen Norway, 2006-2016. Information on breast cancer risk factors was collected by a questionnaire administered with the invitation letter. Cox regression analysis was used to estimate the association between breast cancer and physical activity, body mass index, alcohol consumption, tobacco smoking and menopausal hormone therapy, adjusted for age. During follow-up, 274 women with a benign lesion, 34 women with hyperplasia with atypia and 118 women with carcinoma in situ were diagnosed with invasive breast cancer. We observed an increased risk of breast cancer associated with use of menopausal hormone therapy for women with a benign or premalignant lesion. Alcohol consumption and tobacco smoking showed suggestive increased risk of breast cancer among women with a benign lesion. We were only to a limited degree able to identify associations between modifiable risk factors of breast cancer and the disease among women with a precancerous lesion, and a larger study is needed to confirm or refute associations.
缺乏身体活动、绝经后体质量指数高、饮酒和使用绝经激素治疗是乳腺癌的既定危险因素。对于这些因素是否会影响良性和癌前乳腺病变向浸润性乳腺癌进展的风险，了解较少。这项基于登记的队列研究基于患有癌前病变的女性，对其进行了乳腺癌随访。该队列包括 11270 名患有良性病变、972 名患有不典型增生和 2379 名患有原位癌的女性，这些女性在参加挪威乳房筛查项目 2006-2016 年期间被诊断和治疗。通过随邀请信一起发送的问卷收集乳腺癌风险因素信息。使用 Cox 回归分析估计乳腺癌与身体活动、体质量指数、饮酒、吸烟和绝经激素治疗之间的关联，调整了年龄因素。在随访期间，274 名患有良性病变、34 名患有不典型增生和 118 名患有原位癌的女性被诊断为浸润性乳腺癌。我们观察到，与良性或癌前病变女性使用绝经激素治疗相关的乳腺癌风险增加。在患有良性病变的女性中，饮酒和吸烟与乳腺癌的风险呈显著增加趋势。我们仅在一定程度上能够确定可改变的乳腺癌风险因素与患有癌前病变女性的疾病之间的关联，需要更大规模的研究来证实或反驳这些关联。
