Aaman T B, Stalsberg H, Thomas D B
Institute of Medical Biology, University of Tromsø, Norway.
Int J Cancer. 1998 Feb 20;79(1):39-43. doi: 10.1002/(sici)1097-0215(19980220)79:1<39::aid-ijc8>3.0.co;2-x.
In order to study the relationship between benign breast changes, a family history of breast cancer and breast cancer, extratumoral breast tissue from 1259 breast-cancer patients in the WHO Collaborative Study of Neoplasia and Contraceptives was classified histologically. The occurrence of ductal hyperplasia, ductal atypia, sclerosing adenosis, adenosis, lobular atypia, lactational metaplasia, cysts, apocrine metaplasia, apocrine hyperplasia and atypia, duct ectasia and the epithelial-stromal ratio was evaluated as absent, mild, moderate or marked, along with registration of the quality and number of slides. Information on occurrence of cancer in the family was available for patients' mothers and grandmothers. Logistic-regression analyses showed that the prevalence odds ratios for lactational metaplasia, cysts, duct ectasia and calcification were significantly increased in patients with a family history of breast cancer. Apocrine metaplasia and hyperplasia were not significantly increased. The prevalence rates of ductal atypia (ductal carcinoma in situ and atypical ductal hyperplasia), ductal hyperplasia, sclerosing adenosis, adenosis and high epithelial-stromal ratio did not differ significantly among patients with or without a family history of breast cancer. A family history of other types of cancer did not influence the occurrence of any of the benign components. The findings in the present study are strikingly similar to those in our earlier comparison of extra-tumoral breast tissue in patients from countries with high and low risk of breast cancer. It is reasonable to conclude from this that a history of breast cancer in a woman's mother or grandmother and the factors leading to higher risk of breast cancer in some countries than in others have similar effects on the morphologic evolution of breast cancer through benign and pre-cancerous changes.
为研究乳腺良性病变、乳腺癌家族史与乳腺癌之间的关系，对世界卫生组织肿瘤与避孕药协作研究中1259例乳腺癌患者的肿瘤外乳腺组织进行了组织学分类。评估了导管增生、导管异型增生、硬化性腺病、腺病、小叶异型增生、哺乳期化生、囊肿、大汗腺化生、大汗腺增生及异型增生、导管扩张和上皮-间质比的发生情况，分为无、轻度、中度或重度，并记录切片的质量和数量。患者母亲和祖母有癌症发生情况的信息。逻辑回归分析显示，有乳腺癌家族史的患者中，哺乳期化生、囊肿、导管扩张和钙化的患病优势比显著增加。大汗腺化生和增生没有显著增加。导管异型增生（导管原位癌和非典型导管增生）、导管增生、硬化性腺病、腺病和高上皮-间质比的患病率在有或没有乳腺癌家族史的患者中没有显著差异。其他类型癌症的家族史不影响任何良性成分的发生。本研究的结果与我们早期对乳腺癌高风险和低风险国家患者的肿瘤外乳腺组织比较的结果惊人地相似。由此合理推断，女性母亲或祖母的乳腺癌病史以及导致某些国家乳腺癌风险高于其他国家的因素，通过良性和癌前病变对乳腺癌的形态演变有相似的影响。
