Claus E B, Risch N, Thompson W D, Carter D
Department of Epidemiology, Yale University School of Medicine, New Haven, Connecticut.
Cancer. 1993 Jan 1;71(1):147-53. doi: 10.1002/1097-0142(19930101)71:1<147::aid-cncr2820710124>3.0.co;2-v.
The relationship between breast cancer histology and a number of epidemiologic risk factors associated with breast cancer was examined in 4071 histologically confirmed breast cancer cases aged 20 to 54 years from the Cancer and Steroid Hormone Study.
The distribution of risk factors, which included a family history of breast cancer, age at onset of breast cancer, laterality, race, age at menarche, age at menopause, history of benign breast disease, parity, number of livebirths and number of stillbirths, and age at first childbirth, were examined by histologic subgroup. To determine whether histology is associated with familial risk of breast cancer, a Cox proportional hazards model was used, modeling time to onset of breast cancer among mothers and sisters.
Cases with medullary carcinoma were found to be significantly younger than cases with other tumor types in these data. In addition, medullary carcinoma was reported more frequently among black cases than among white cases. Cases with lobular carcinoma in situ were significantly more likely to have a mother and/or sister affected with breast cancer than cases with other tumor types and were also more likely to be bilateral, although few of these cases were both bilateral and reported a family history of breast cancer. The highest reported rates of benign breast disease occurred in cases with carcinoma in situ (both ductal and lobular) and tubular carcinoma. The remaining risk factors showed no association with histology.
The current study clarifies the extent and nature of the relationship between breast cancer histology and epidemiologic risk factors including a family history of breast cancer.
在癌症与类固醇激素研究中,对4071例年龄在20至54岁、经组织学确诊的乳腺癌病例进行了研究,以探讨乳腺癌组织学与一些与乳腺癌相关的流行病学危险因素之间的关系。
通过组织学亚组检查危险因素的分布情况,这些危险因素包括乳腺癌家族史、乳腺癌发病年龄、肿瘤侧别、种族、初潮年龄、绝经年龄、良性乳腺疾病史、生育情况(产次、活产数和死产数)以及首次生育年龄。为了确定组织学是否与乳腺癌的家族风险相关,使用了Cox比例风险模型,对母亲和姐妹中乳腺癌发病时间进行建模。
在这些数据中,发现髓样癌病例比其他肿瘤类型的病例明显年轻。此外,黑人病例中髓样癌的报告频率高于白人病例。原位小叶癌病例比其他肿瘤类型的病例更有可能有母亲和/或姐妹患乳腺癌,并且也更有可能是双侧发病,尽管这些病例中很少既有双侧发病又有乳腺癌家族史。良性乳腺疾病报告率最高的是原位癌(导管原位癌和小叶原位癌)和管状癌病例。其余危险因素与组织学无关联。
本研究阐明了乳腺癌组织学与包括乳腺癌家族史在内的流行病学危险因素之间关系的范围和性质。