Orr R K, Fraher K M
Fallon Clinic Breast Center, Worcester, MA, USA.
Breast Cancer Res Treat. 1995 Apr;34(1):71-6. doi: 10.1007/BF00666493.
Although multiparous women have a decreased incidence of breast cancer, several series have observed that multiparous women have a higher risk of axillary nodal metastases and diminished survival.
To study this hypothesis in greater detail, this study analyzed data from 223 consecutive women with clinically operable (T1-3, N0-1, M0) breast cancer, all of whom had undergone axillary node dissection (AND) by one surgeon (83 mastectomy/AND, 140 lumpectomy/AND). The number of pregnancies and other hormonally related factors were recorded. Results were compared to pathologic data (node status, tumor size, estrogen and progesterone receptors).
Seventy-eight patients (35.0%) had positive axillary nodes. Increasing parity was associated with an increased likelihood of positive nodes (Odds ratio 1.22 (95% CI: 1.04-1.42), p = 0.012) as was increasing tumor size (Odds ratio 1.31 (1.07-1.59), p = 0.007). The effect of parity was independent of tumor size, age, or hormone receptors.
In this series, which includes only operatively staged patients, increasing parity is associated with nodal positivity. This effect is of a magnitude similar to that of increasing tumor size, and confirms observations from other studies. Information regarding parity may be useful for prognostic purposes, as well as providing insights into basic breast cancer biology.
尽管经产妇患乳腺癌的发病率较低，但有几项研究系列观察到，经产妇发生腋窝淋巴结转移的风险较高且生存率降低。
为更详细地研究这一假设，本研究分析了223例连续的临床可手术（T1-3，N0-1，M0）乳腺癌女性患者的数据，所有患者均由一名外科医生进行了腋窝淋巴结清扫术（83例行乳房切除术/腋窝淋巴结清扫术，140例行肿块切除术/腋窝淋巴结清扫术）。记录怀孕次数及其他与激素相关的因素。将结果与病理数据（淋巴结状态、肿瘤大小、雌激素和孕激素受体）进行比较。
78例患者（35.0%）腋窝淋巴结阳性。产次增加与淋巴结阳性可能性增加相关（优势比1.22（95%可信区间：1.04-1.42），p = 0.012），肿瘤大小增加也是如此（优势比1.31（1.07-1.59），p = 0.007）。产次的影响独立于肿瘤大小、年龄或激素受体。
在本系列研究中，仅纳入了手术分期的患者，产次增加与淋巴结阳性相关。这种影响的程度与肿瘤大小增加相似，并证实了其他研究的观察结果。关于产次的信息可能对预后评估有用，也有助于深入了解乳腺癌的基础生物学。
