Trentham-Dietz A, Newcomb P A, Storer B E, Longnecker M P, Baron J, Greenberg E R, Willett W C
University of Wisconsin Comprehensive Cancer Center, Madison 53706, USA.
Am J Epidemiol. 1997 Jun 1;145(11):1011-9. doi: 10.1093/oxfordjournals.aje.a009057.
The relation between body size and breast cancer remains uncertain, particularly with regard to differences between pre- and postmenopausal women. The authors examined whether height, weight, body mass index, and weight change were associated with breast cancer risk among pre- and postmenopausal women. This population-based case-control study included women aged 20-74 years (n = 6,548) who were diagnosed with invasive breast cancer during 1988-1991 in Maine, Massachusetts, New Hampshire, and Wisconsin. Similarly aged control women (n = 9,057) were selected at random from driver's license files and Health Care Financing Administration files. Height, weight, and information on other breast cancer risk factors were ascertained by telephone interview, and logistic regression was used to estimate multivariate-adjusted odds ratios and 95% confidence intervals. Among premenopausal women, the adjusted odds ratio for the upper quintile group of height relative to the lowest was 1.36 (95% confidence interval (CI) 1.05-1.76). The heaviest premenopausal women had a lower risk (odds ratio (OR) = 0.87, 95% CI 0.70-1.10). Among postmenopausal women, the adjusted odds ratios were higher for the upper quintile categories of both height (OR = 1.27, 95% CI 1.11-1.45) and weight (OR = 1.57, 95% CI 1.37-1.79). Weight gain since ages 18 and 35 years was associated with increased postmenopausal breast cancer risk, and risk was lower in women who had lost weight. These findings suggest that programs to avoid weight gain merit study as a means to reduce risk of postmenopausal breast cancer.
身体大小与乳腺癌之间的关系仍不明确，尤其是在绝经前和绝经后女性的差异方面。作者研究了身高、体重、体重指数和体重变化与绝经前和绝经后女性患乳腺癌风险之间是否存在关联。这项基于人群的病例对照研究纳入了1988 - 1991年期间在缅因州、马萨诸塞州、新罕布什尔州和威斯康星州被诊断为浸润性乳腺癌的20 - 74岁女性（n = 6548）。从驾照档案和医疗保健财务管理局档案中随机选取了年龄相仿的对照女性（n = 9057）。通过电话访谈确定身高、体重以及其他乳腺癌风险因素的信息，并使用逻辑回归来估计多变量调整后的优势比和95%置信区间。在绝经前女性中，身高最高五分位数组相对于最低组的调整后优势比为1.36（95%置信区间（CI）1.05 - 1.76）。体重最重的绝经前女性风险较低（优势比（OR）= 0.87，95% CI 0.70 - 1.10）。在绝经后女性中，身高（OR = 1.27，95% CI 1.11 - 1.45）和体重（OR = 1.57，95% CI 1.37 - 1.79）的最高五分位数类别调整后的优势比更高。自18岁和35岁以来体重增加与绝经后乳腺癌风险增加相关，而体重减轻的女性风险较低。这些发现表明，避免体重增加的项目值得作为降低绝经后乳腺癌风险的一种手段进行研究。
