Breast Center, Department of General Surgery, Nanfang Hospital, Southern Medical University, No.1838 North Guangzhou Avenue, Guangzhou, 510515, China.
Institute of Hematological Research, Shaanxi Provincial People's Hospital, Xi'an, 710000, China.
BMC Cancer. 2022 May 12;22(1):534. doi: 10.1186/s12885-022-09604-2.
Several studies have demonstrated that cardiovascular risk factors play a role in the etiology of breast cancer. However, the combined effect of cardiovascular risk factors on the risk of breast cancer is still uncertain.
Data from the Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort of middle-aged women, were used to investigate the association of individual and combined cardiovascular risk factors with breast cancer. Cox proportional hazards models were applied to calculate the hazard ratio (HR) and 95% confidence intervals (CI).
A total of 7501 women were included. During a mean follow-up of 19.7 years, 576 women were diagnosed with breast cancer. White women and premenopausal status were independently associated with increased risk of breast cancer. Of the individual cardiovascular risk factors, only obesity was independently associated with an increased risk of breast cancer (HR 1.29, 95% CI 1.04-1.61). Compared with women without cardiovascular risk factors, women having three or greater, but not those with fewer than three cardiovascular risk factors, had a significantly higher risk of developing breast cancer (HR 1.27, 95% CI 1.06-1.53). Subgroup analyses indicated that women with three or greater cardiovascular risk factors had higher risk of breast cancer among postmenopausal Black women, but not among premenopausal Black and White women.
Combinations of cardiovascular risk factors are associated with increased risk of breast cancer in middle-aged women, especially in postmenopausal Black women. Joint interventions to modify cardiovascular risk factors could be used to prevent breast cancer in these higher-risk individuals.
多项研究表明心血管危险因素在乳腺癌的发病机制中起作用。然而，心血管危险因素对乳腺癌风险的综合影响仍不确定。
使用来自社区动脉粥样硬化风险（ARIC）研究的数据，这是一项中年女性的前瞻性队列研究，调查个体和联合心血管危险因素与乳腺癌之间的关联。应用 Cox 比例风险模型计算风险比（HR）和 95%置信区间（CI）。
共纳入 7501 名女性。在平均 19.7 年的随访期间，576 名女性被诊断患有乳腺癌。白种女性和绝经前状态与乳腺癌风险增加独立相关。在个体心血管危险因素中，只有肥胖与乳腺癌风险增加独立相关（HR 1.29，95%CI 1.04-1.61）。与无心血管危险因素的女性相比，具有 3 个或更多心血管危险因素的女性发生乳腺癌的风险显著增加（HR 1.27，95%CI 1.06-1.53）。亚组分析表明，具有 3 个或更多心血管危险因素的女性绝经后黑种女性乳腺癌风险较高，但绝经前黑种和白种女性则不然。
心血管危险因素的组合与中年女性乳腺癌风险增加相关，尤其是绝经后黑种女性。联合干预以改变心血管危险因素可能用于预防这些高风险个体的乳腺癌。
