Department of Oncology, Mayo Clinic, Rochester, MN, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
Breast. 2022 Dec;66:272-277. doi: 10.1016/j.breast.2022.11.004. Epub 2022 Nov 9.
Few studies have examined detailed features of pregnancy and the postpartum period as potential risk factors for early onset breast cancer (BC) by molecular subtype. These data may have value for improving risk assessment and prevention.
We surveyed parous enrollees in the prospective Mayo Clinic Breast Disease Registry (MCBDR) who had been diagnosed with BC at age <55 years between 2015 and 2020. Summary statistics were used to describe survey responses and reproductive risk factors by BC subtype (defined by estrogen/progesterone receptors and human epidermal growth factor receptor expression, nurse-abstracted from the medical record). Associations were assessed with Kruskal-Wallis and Chi-Square tests, followed by age-adjusted linear and logistic regression models. We compared results from this parous cohort to those from a separate cohort of nulliparous MCBDR participants with BC diagnosed at age <55 years.
In 436 parous respondents with subtype data abstracted, we identified a higher frequency of BRCA1 mutation, earlier age at diagnosis, and lower BI in patients with triple negative BC. Comparing parous to nulliparous young women with breast cancer, the proportion with TNBC was larger in the latter (12.2% vs. 15.1%, p = 0.03).
Early age at diagnosis and deleterious BRCA1 mutation were more frequent among TNBC patients. In addition, parous young women with TNBC had a lower BI than those with other BC subtypes, a hypothesis-generating finding that supports the need for additional research on the cycle of pregnancy-lactation-postpartum involution and BC etiology.
很少有研究通过分子亚型检查妊娠和产后期间的详细特征，以作为早期乳腺癌（BC）的潜在风险因素。这些数据可能对改善风险评估和预防具有重要意义。
我们调查了在 2015 年至 2020 年期间在年龄<55 岁时被诊断患有 BC 的前瞻性 Mayo 诊所乳腺疾病登记处（MCBDR）的多产妇入组者。使用汇总统计数据描述 BC 亚型（通过雌激素/孕激素受体和人表皮生长因子受体表达来定义，由病历中的护士摘录）的调查应答和生殖风险因素。使用 Kruskal-Wallis 和卡方检验评估关联，然后使用年龄调整线性和逻辑回归模型进行评估。我们将多产妇队列的结果与年龄<55 岁被诊断患有 BC 的独立的 MCBDR 未产妇队列的结果进行了比较。
在 436 名具有提取的亚型数据的多产妇应答者中，我们发现三阴性乳腺癌患者的 BRCA1 突变频率更高、诊断年龄更早、BI 值更低。与年轻患有乳腺癌的未产妇相比，后者中 TNBC 的比例更大（12.2% vs. 15.1%，p=0.03）。
TNBC 患者中，诊断年龄更早和有害的 BRCA1 突变更为常见。此外，与其他 BC 亚型相比，多产妇的 TNBC 患者 BI 值更低，这一假设产生的发现支持进一步研究妊娠-哺乳-产后退化周期与 BC 病因学之间的关系。
