Brinton L A, Hoover R, Fraumeni J F
J Natl Cancer Inst. 1982 Oct;69(4):817-22.
A case-control study, conducted among participants in the Breast Cancer Detection Demonstration Project, obtained detailed information on family history of breast cancer and other risk factors from 1,362 breast cancer patients and 1,250 control subjects. An affected first-degree relative was reported by 22.4% of the patients and 12.2% of the control subjects. This finding was associated with a twofold increased risk of breast cancer, although greater elevations in risk were seen in younger study subjects and in those reporting both an affected mother and a sister. Analysis of other risk factors showed that, compared to women without a family history of breast cancer, control subjects with a family history of breast cancer tended to have early or late menarche, were older at first childbirth, and were younger at oophorectomy. In addition, the effect of family history on breast cancer risk was modified by age at menarche, but not by age at first birth or type of menopause. These findings suggest that familial susceptibility to breast cancer may be mediated through hormonal factors that operate early in a woman's life. A synergistic relationship was also observed between family history of breast cancer and the occurrence of multiple biopsies for benign breast disease, although the mechanisms for this relationship remain to be elucidated.
一项在乳腺癌检测示范项目参与者中开展的病例对照研究，从1362例乳腺癌患者和1250名对照对象那里获取了关于乳腺癌家族史及其他风险因素的详细信息。22.4%的患者和12.2%的对照对象报告有一位患癌的一级亲属。这一发现与乳腺癌风险增加两倍相关，不过在较年轻的研究对象以及报告母亲和姐妹均患癌的对象中，风险升高幅度更大。对其他风险因素的分析显示，与无乳腺癌家族史的女性相比，有乳腺癌家族史的对照对象初潮往往较早或较晚，首次生育年龄较大，卵巢切除时年龄较小。此外，家族史对乳腺癌风险的影响因初潮年龄而改变，但不受首次生育年龄或绝经类型的影响。这些发现表明，乳腺癌的家族易感性可能是通过在女性生命早期起作用的激素因素介导的。乳腺癌家族史与因良性乳腺疾病进行多次活检的发生之间也观察到一种协同关系，尽管这种关系的机制仍有待阐明。
