Ferrero J M, Namer M
Centre Antoine-Lacassagne, Nice.
Arch Anat Cytol Pathol. 1994;42(5):198-205.
Breast cancer is a major public health problem. In 1980, breast cancer represented 18% of all cancers in women throughout the world. The worldwide incidence of breast cancer is increasing by 1.5% per annum and is influenced by geographical factors and by age. In France, this disease represents 19% of cancer deaths in women and is the commonest cause of cancer death in women. Several risk factors have been suspected, but many points remain obscure. The age of the menarche, the age of menopause, parity and the age of the first pregnancy influence the incidence of breast cancer. The use of oral contraceptives and hormone replacement therapy for menopause do not appear to affect the development of malignant breast disease, except, perhaps, in certain subgroups of patients, but this remains to be confirmed. The risk is increased by a fatty diet and by excessive alcohol consumption. It is now generally accepted that a family history of breast cancer is associated with an increased risk. In the future, a more precise understanding of genetic anomalies related to cancer will allow early diagnosis, particularly of familial forms. Many unresolved aspects of the risk factors of breast cancer could be elucidated by cohort studies.
乳腺癌是一个重大的公共卫生问题。1980年,乳腺癌占全球女性所有癌症的18%。全球乳腺癌发病率正以每年1.5%的速度上升,且受地理因素和年龄影响。在法国,这种疾病占女性癌症死亡人数的19%,是女性癌症死亡的最常见原因。人们怀疑有几个风险因素,但许多问题仍不明确。初潮年龄、绝经年龄、生育状况和首次怀孕年龄会影响乳腺癌的发病率。使用口服避孕药和绝经后激素替代疗法似乎不会影响乳腺恶性疾病的发展,也许在某些特定患者亚组中除外,但这仍有待证实。高脂肪饮食和过量饮酒会增加患病风险。现在人们普遍认为乳腺癌家族史与患病风险增加有关。未来,对与癌症相关的基因异常有更精确的了解将有助于早期诊断,尤其是对家族性类型。队列研究可以阐明乳腺癌风险因素中许多未解决的方面。