Vihko R K, Apter D L
Cancer Surv. 1986;5(3):561-71.
The search for major endocrine abnormalities as causes for breast cancer has not been successful, whether it has been directed to patients with this disease, or to different groups or populations at risk, such as women who have had an early menarche. There were, however, clear-cut differences in a number of variables when the pubertal development of girls with an early menarche was compared with that in other girls. The girls with an early menarche, compared to those with a late menarche, had an early increase in serum concentrations of follicle stimulating hormone, higher circulating oestradiol concentrations before and for several years after menarche and lower serum sex hormone-binding globulin concentrations for several years after menarche, the last two leading to higher 'free oestradiol indices' in the serum. Early menarche was characterized by early onset of ovulatory cycles. We found that the times from menarche until 50% of the cycles were ovulatory were about 1, 3 and 4.5 years, when the ages at menarche were less than 12, 12-12.9 and more than or equal to 13 years, respectively. In addition, the luteal phase of the menstrual cycles of subjects with an early menarche was adequate more frequently than that of subjects with a later menarche. These findings are compatible with the view that girls with an early menarche have a more profound decrease in the sensitivity of the hypothalamic-pituitary axis to the negative feedback of circulating steroids. The associations between endocrine variables and body weight and percentage of fat seem to be primarily determined by the endocrine variables. Altogether the data on early menarche suggest that early-onset regular cyclic ovarian function is related to the increased risk of breast cancer that is associated with this category of women. Athletic activities may delay menarche, which may have relevance for reducing the risk of breast cancer.
将乳腺癌病因归结为主要内分泌异常的研究尚未成功，无论是针对乳腺癌患者，还是针对不同的高危群体或人群，如月经初潮早的女性。然而，当比较月经初潮早的女孩与其他女孩的青春期发育时，在一些变量上存在明显差异。月经初潮早的女孩与月经初潮晚的女孩相比，血清卵泡刺激素浓度早期升高，月经初潮前及初潮后数年循环雌二醇浓度较高，月经初潮后数年血清性激素结合球蛋白浓度较低，后两者导致血清中“游离雌二醇指数”较高。月经初潮早的特征是排卵周期开始早。我们发现，当月经初潮年龄分别小于12岁、12 - 12.9岁和大于或等于13岁时，从月经初潮到50%的周期排卵的时间分别约为1年、3年和4.5年。此外，月经初潮早的受试者月经周期的黄体期比月经初潮晚的受试者更频繁地正常。这些发现与月经初潮早的女孩下丘脑 - 垂体轴对循环类固醇负反馈的敏感性下降更为明显的观点一致。内分泌变量与体重和脂肪百分比之间的关联似乎主要由内分泌变量决定。总之，关于月经初潮早的数据表明，早发性规律的周期性卵巢功能与这类女性患乳腺癌风险增加有关。体育活动可能会推迟月经初潮，这可能与降低患乳腺癌风险有关。
