Shin Yeonjin, Nahm Gyuho, Seo Jiwon, Lee Jin Li, Han Gwan Hee, Yoon Sang-Hee, Noh Ji Hyun, Kim Myounghwan, Yuk Jin-Sung
Independent Researcher, Seoul, Korea.
Applewoman Clinic, Seoul, Korea.
J Breast Cancer. 2025 Aug;28(4):215-227. doi: 10.4048/jbc.2025.0031. Epub 2025 Jun 16.
Despite numerous previous studies, the relationship between hysterectomies and breast cancer risk remains unclear. This study aimed to assess whether hysterectomies are significantly associated with a reduced risk of breast cancer in Korean women using data from the National Health Insurance Service database of South Korea.
We conducted a retrospective cohort study of South Korean women aged 40-59 years who underwent hysterectomies for benign reasons or underwent a health check-up between 2003 and 2011. To minimize confounding factors, a 1:1 propensity score matching (PSM) was used to balance the groups based on key covariates. The participants were followed up until December 31, 2020. Stratified Cox proportional hazards regression analysis was performed to assess the association between hysterectomies and breast cancer risk.
After 1:1 PSM, 13,148 women were assigned to the hysterectomy or non-hysterectomy groups. Breast cancer occurred in 242 (1.8%) and 233 (1.8%) women in the non-hysterectomy and hysterectomy groups, respectively ( = 0.711). After adjusting for confounders, hysterectomy with or without adnexal surgery was not significantly associated with breast cancer risk (hazard ratio [HR], 0.937; 95% confidence interval [CI], 0.775-1.132 for hysterectomy with/without adnexal surgery; HR, 0.957; 95% CI, 0.779-1.176 for hysterectomy without adnexal surgery; and HR, 0.833; 95% CI, 0.513-1.353 for hysterectomy with adnexal surgery). No significant association was found when analyzing surgical methods or age at natural menopause.
Our study found no association between hysterectomies and breast cancer risk, which is consistent with previous studies that reported a null association.
尽管此前有大量研究，但子宫切除术与乳腺癌风险之间的关系仍不明确。本研究旨在利用韩国国民健康保险服务数据库的数据，评估子宫切除术是否与韩国女性乳腺癌风险降低显著相关。
我们对2003年至2011年间因良性原因接受子宫切除术或进行健康检查的40至59岁韩国女性进行了一项回顾性队列研究。为尽量减少混杂因素，采用1:1倾向评分匹配（PSM）根据关键协变量平衡各组。对参与者进行随访至2020年12月31日。进行分层Cox比例风险回归分析以评估子宫切除术与乳腺癌风险之间的关联。
经过1:1 PSM后，13148名女性被分配到子宫切除术组或非子宫切除术组。非子宫切除术组和子宫切除术组分别有242名（1.8%）和233名（1.8%）女性发生乳腺癌（P = 0.711）。在调整混杂因素后，无论是否进行附件手术的子宫切除术与乳腺癌风险均无显著关联（风险比[HR]，0.937；95%置信区间[CI]，对于有/无附件手术的子宫切除术为0.775 - 1.132；对于无附件手术的子宫切除术，HR，0.957；95% CI，0.779 - 1.176；对于有附件手术的子宫切除术，HR，0.833；95% CI，0.513 - 1.353）。在分析手术方法或自然绝经年龄时未发现显著关联。
我们的研究发现子宫切除术与乳腺癌风险之间无关联，这与之前报道无关联的研究一致。
