Wei Shu Qin, Leduc Valérie, Potter Brian, Paradis Gilles, Ayoub Aimina, Healy-Profitós Jessica, Maniraho Amanda, Lewin Antoine, Auger Nathalie
Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Quebec, Canada.
Int J Cancer. 2025 Nov 15;157(10):2025-2032. doi: 10.1002/ijc.70025. Epub 2025 Jun 25.
Patients with preeclampsia have a reduced risk of breast cancer, but it is not clear if the protective effect extends to all types of breast tumors. Our objective was to determine the association of preeclampsia with ductal, lobular, and other breast cancer histology. We conducted a longitudinal cohort study of 1,459,716 patients who had pregnancies between 1989 and 2022 in Quebec, Canada. The main exposure measure was preeclampsia. The outcome was breast cancer, including ductal, lobular, and other histological subtypes diagnosed up to 34 years after childbirth. We included in situ, localized invasive, and metastatic breast cancer. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between preeclampsia and breast cancer histology, adjusted for maternal characteristics. Patients with preeclampsia had a lower incidence of breast cancer than patients without preeclampsia (82.1 vs. 111.7 per 100,000 person-years). Preeclampsia was associated with a 16% lower risk of breast cancer compared with no preeclampsia (HR 0.84, 95% CI 0.79-0.89), including a 14% lower risk of ductal (HR 0.86, 95% CI 0.81-0.93) and 31% lower risk of lobular tumors (HR 0.69, 95% CI 0.55-0.87). The protective association was present for in situ, localized invasive, and metastatic breast tumors. Preeclampsia was not associated with mucinous, medullary, papillary, or other breast cancer histology. We conclude that patients with preeclampsia are less likely to develop ductal and lobular breast cancer than patients with normotensive pregnancies, but do not have a reduced risk of other types of breast cancer.
先兆子痫患者患乳腺癌的风险较低，但尚不清楚这种保护作用是否适用于所有类型的乳腺肿瘤。我们的目的是确定先兆子痫与导管癌、小叶癌及其他乳腺癌组织学类型之间的关联。我们对1989年至2022年在加拿大魁北克怀孕的1,459,716名患者进行了一项纵向队列研究。主要暴露指标是先兆子痫。结局是乳腺癌，包括分娩后34年内诊断出的导管癌、小叶癌及其他组织学亚型。我们纳入了原位癌、局限性浸润癌和转移性乳腺癌。我们使用Cox回归模型来估计先兆子痫与乳腺癌组织学类型之间关联的风险比（HR）和95%置信区间（CI），并对产妇特征进行了校正。与未患先兆子痫的患者相比，患先兆子痫的患者乳腺癌发病率更低（每10万人年分别为82.1例和111.7例）。与未患先兆子痫相比，先兆子痫与乳腺癌风险降低16%相关（HR 0.84，95% CI 0.79 - 0.89），包括导管癌风险降低14%（HR 0.86，95% CI 0.81 - 0.93）和小叶癌风险降低31%（HR 0.69，95% CI 0.55 - 0.87）。这种保护关联在原位癌、局限性浸润癌和转移性乳腺肿瘤中均存在。先兆子痫与黏液性、髓样、乳头状或其他乳腺癌组织学类型无关。我们得出结论，与血压正常的孕妇相比，先兆子痫患者发生导管癌和小叶癌的可能性较小，但患其他类型乳腺癌的风险并未降低。
