Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea.
Department of Surgery, Sanggye Paik Hospital, School of Medicine, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea.
Sci Rep. 2023 Oct 5;13(1):16772. doi: 10.1038/s41598-023-43443-w.
Both the uterus and breasts have sex hormone dependence, yet there are few studies on the association between breast disease and uterine fibroids (UFs). The purpose of this study was to investigate the incidence of benign breast disease (BBD), carcinoma in situ (CIS), and breast cancer (BC) in women treated for UFs compared to women who were not treated for UFs. This retrospective cohort study used national health insurance data from January 1st, 2011, to December 31st, 2020. We selected women between 20 and 50 years old who (1) were treated for UFs (UF group) or (2) visited medical institutions for personal health screening tests without UFs (control group). We analyzed independent variables such as age, socioeconomic status (SES), region, Charlson comorbidity index (CCI), delivery status, menopausal status, menopausal hormone therapy (MHT), endometriosis, hypertension (HTN), diabetes mellitus (DM), and dyslipidemia based on the first date of uterine myomectomy in the UF group and the first visiting date for health screening in the non-UF group. There were 190,583 and 439,940 participants in the UF and control groups, respectively. Compared with those of the control group, the RRs of BBD, CIS, and BC were increased in the UF group. The hazard ratios (HRs) of BBD, CIS, and BC in the UF group were 1.335 (95% confidence interval (CI) 1.299-1.372), 1.796 (95% CI 1.542-2.092), and 1.3 (95% CI 1.198-1.41), respectively. When we analyzed the risk of BC according to age at inclusion, UFs group had the increased risk of BCs in all age groups in comparison with control group. Women with low SES (HR 0.514, 95% CI 0.36-0.734) and living in rural areas (HR 0.889, 95% CI 0.822-0.962) had a lower risk of BC. Our study showed that women with UFs had a higher risk of BBD, CIS, and BC than those without UFs. This result suggests that women with UFs should be more conscious of BC than those without UFs. Therefore, doctors should consider recommending regular breast self-exams, mammography, or ultrasound for the early detection of BC in women with UFs.
子宫和乳房都有性激素依赖性，但关于乳房疾病与子宫肌瘤（UFs）之间的关联的研究较少。本研究旨在调查与未接受 UFs 治疗的女性相比，接受 UFs 治疗的女性中良性乳腺疾病（BBD）、原位癌（CIS）和乳腺癌（BC）的发生率。这项回顾性队列研究使用了 2011 年 1 月 1 日至 2020 年 12 月 31 日的国家健康保险数据。我们选择了年龄在 20 至 50 岁之间的女性：（1）接受 UFs 治疗（UF 组）或（2）因个人健康筛查而就诊医疗机构且未接受 UFs 治疗（对照组）。我们根据 UF 组中子宫肌切除术的首次日期和非 UF 组中健康筛查的首次就诊日期，分析了年龄、社会经济地位（SES）、地区、Charlson 合并症指数（CCI）、分娩状况、绝经状态、绝经激素治疗（MHT）、子宫内膜异位症、高血压（HTN）、糖尿病（DM）和血脂异常等独立变量。UF 组和对照组分别有 190583 和 439940 名参与者。与对照组相比，UF 组的 BBD、CIS 和 BC 的 RR 增加。UF 组的 BBD、CIS 和 BC 的风险比（HR）分别为 1.335（95%置信区间（CI）1.299-1.372）、1.796（95% CI 1.542-2.092）和 1.3（95% CI 1.198-1.41）。当我们根据纳入时的年龄分析 BC 的风险时，与对照组相比，UF 组在所有年龄组中都有更高的 BC 风险。低 SES（HR 0.514，95%CI 0.36-0.734）和居住在农村地区（HR 0.889，95%CI 0.822-0.962）的女性患 BC 的风险较低。我们的研究表明，患有 UFs 的女性患 BBD、CIS 和 BC 的风险高于未患有 UFs 的女性。这一结果表明，患有 UFs 的女性应比未患有 UFs 的女性更有意识地进行 BC 筛查。因此，医生应考虑建议接受 UFs 治疗的女性定期进行乳腺癌自我检查、乳房 X 线摄影或超声检查，以早期发现 BC。
