Pastides H, Kelsey J L, Holford T R, LiVolsi V A
Am J Epidemiol. 1985 Mar;121(3):440-7. doi: 10.1093/oxfordjournals.aje.a114016.
A case-control study of 255 women with fibrocystic breast lesions and 790 controls was conducted at two hospitals in New Haven, Connecticut during 1977-1979. Cases were found to weigh significantly less than controls, and were more likely than controls to have: a first-degree female relative with a history of breast cancer; a higher level of education; a recent history of regular gynecologic checkups; and (if under age 45 years) a later age at first pregnancy. They were less likely to have had a surgical menopause. The degree of ductal epithelial atypia in breast biopsy specimens was evaluated in order to see whether epidemiologic characteristics differed according to the degree of ductal atypia. The only variable to show a linear relationship with ductal atypia was a recent history of regular gynecologic checkups; those with no or minimal atypia were more likely to have had recent checkups than those with high atypia scores. This study thus gives no evidence that known risk factors for breast cancer are more strongly associated with fibrocystic breast disease with a high degree of atypia than with fibrocystic breast disease with a low degree of atypia. It also provides data to support the belief that women having frequent gynecologic checkups are more likely to be included as cases in case-control studies of fibrocystic breast disease, and particularly in the groups with no or minimal atypia, than those not having frequent checkups.
1977年至1979年期间，在康涅狄格州纽黑文的两家医院对255名患有纤维囊性乳腺病变的女性和790名对照者进行了一项病例对照研究。发现病例的体重明显低于对照者，并且比对照者更有可能具有以下特征：有乳腺癌病史的一级女性亲属；受教育程度较高；近期有定期妇科检查史；以及（如果年龄在45岁以下）初孕年龄较晚。她们进行手术绝经的可能性较小。对乳腺活检标本中的导管上皮异型程度进行了评估，以观察流行病学特征是否根据导管异型程度而有所不同。唯一与导管异型呈线性关系的变量是近期有定期妇科检查史；与异型评分高的人相比，无或异型程度最小的人近期进行检查的可能性更大。因此，本研究没有证据表明，已知的乳腺癌危险因素与高度异型的纤维囊性乳腺病的关联比与低度异型的纤维囊性乳腺病的关联更强。它还提供了数据支持这样一种观点，即与没有频繁进行妇科检查的女性相比，频繁进行妇科检查的女性在纤维囊性乳腺病的病例对照研究中，尤其是在无或异型程度最小的组中，更有可能被纳入病例组。
