Wrensch M, Petrakis N L, King E B, Lee M M, Miike R
Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco 94143-0560.
Am J Epidemiol. 1993 Apr 15;137(8):829-33. doi: 10.1093/oxfordjournals.aje.a116744.
The authors previously reported an increased risk of breast cancer in women from the San Francisco Bay Area first enrolled between 1973 and 1980 with proliferative cytologic findings (hyperplasia, moderate hyperplasia, and atypia) compared with women with normal cytologic findings in breast fluids obtained by nipple aspiration and with women from whom breast fluid could not be obtained. To look for factors which might modify the risks associated with cytology, the authors examined several standard breast cancer risk factors: parity, age at first pregnancy, age at menarche, family history of breast cancer, and prior history of breast biopsy. Among women aged 30 years or over, only prior biopsy modified the effect of proliferative cytologic findings on the risk of breast cancer (p < 0.10). For those women with no prior biopsy, breast cancer incidence was 5% (47 of 985) among women with normal cytology and 5% (13 of 277) among women with proliferative findings, whereas among those women with normal cytology and 18% (11 of 62) among women with proliferative cytology. Age-adjusted as well as multivariate-adjusted relative risks indicated that the increased risk of breast cancer associated with proliferative cytologic findings was largely confined to women who had a prior history of breast biopsy.
作者之前报告称，与通过乳头抽吸获得的乳腺液细胞学检查结果正常的女性以及无法获得乳腺液的女性相比，1973年至1980年首次入组的旧金山湾区女性中，具有增殖性细胞学发现（增生、中度增生和异型性）的女性患乳腺癌的风险增加。为了寻找可能改变与细胞学相关风险的因素，作者研究了几个标准的乳腺癌风险因素：生育情况、首次怀孕年龄、初潮年龄、乳腺癌家族史以及既往乳腺活检史。在30岁及以上的女性中，只有既往活检改变了增殖性细胞学发现对患乳腺癌风险的影响（p<0.10）。对于那些没有既往活检的女性，细胞学检查结果正常的女性中乳腺癌发病率为5%（985例中有47例），有增殖性发现的女性中为5%（277例中有13例）；而对于那些有既往活检的女性，细胞学检查结果正常的女性中乳腺癌发病率为18%（62例中有11例），有增殖性细胞学检查结果的女性中为18%（62例中有11例）。年龄调整以及多变量调整后的相对风险表明，与增殖性细胞学发现相关的乳腺癌风险增加主要局限于有既往乳腺活检史的女性。
