Migraine History and Breast Cancer Risk Among Postmenopausal Women
Migraine History and Breast Cancer Risk Among Postmenopausal Women
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DOI：
10.1200/jco.2009.25.0423
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发表时间：
2010-02-20
影响因子：
45.3
通讯作者：
Prentice, Ross
中科院分区：
文献类型：
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作者：
Li, Christopher I.;Mathes, Robert W.;Prentice, Ross
目的偏头痛和乳腺癌都是激素介导的。最近的两份报告表明，有偏头痛病史的女性患绝经后乳腺癌的风险可能低于从未患过偏头痛的女性。这一发现需要证实；特别是，需要对使用非甾体抗炎药（NSAID）的影响进行评估，因为许多研究表明，使用非甾体抗炎药也可能降低乳腺癌风险。方法：我们评估了91116名妇女自报告偏头痛病史与绝经后乳腺癌发病率之间的关系，这些妇女参加了1993年至1998年妇女健康倡议观察性研究前瞻性队列，年龄在50至79岁之间。截至2005年9月15日，共有4,006名符合条件的乳腺癌患者被诊断出来。结果：有偏头痛病史的女性患乳腺癌的风险低于无偏头痛病史的女性（风险比[HR]， 0.89; 95% CI, 0.80 ~ 98）。这一风险与近期使用非甾体抗炎药无关。侵袭性雌激素受体阳性和孕激素受体阳性肿瘤的风险降低更为明显（HR, 0.83; 95% CI， 0.71至0.97），而侵袭性er阴性/ pr阴性肿瘤的风险没有降低（HR, 1.16; 95% CI， 0.86至1.57），这种风险估计差异具有临界统计学意义（P = 0.06）。结论：本研究支持偏头痛病史与较低乳腺癌风险相关的假设，并且这种关系与近期使用非甾体抗炎药无关。
PurposeBoth migraine and breast cancer are hormonally mediated. Two recent reports indicate that women with a migraine history may have a lower risk of postmenopausal breast cancer than those who never suffered migraines. This finding requires confirmation; in particular, an assessment of the influence of use of nonsteroidal anti-inflammatory drugs (NSAID) is needed, because many studies indicate that NSAID use also may confer a reduction in breast cancer risk.MethodsWe assessed the relationship between self-reported history of migraine and incidence of postmenopausal breast cancer in 91,116 women enrolled on the Women's Health Initiative Observational Study prospective cohort from 1993 to 1998 at ages 50 to 79 years. Through September 15, 2005, there were 4,006 eligible patients with breast cancer diagnosed.ResultsWomen with a history of migraine had a lower risk of breast cancer (hazard ratio [HR], 0.89; 95% CI, 0.80 to 98) than women without a migraine history. This risk did not vary by recent NSAID use. The lower risk was somewhat more pronounced for invasive estrogen-receptor-positive and progesterone-receptor-positive tumors (HR, 0.83; 95% CI, 0.71 to 0.97), as no reduction in risk was observed for invasive ER-negative/PR-negative tumors (HR, 1.16; 95% CI, 0.86 to 1.57), and this difference in risk estimates was borderline statistically significant (P = .06).ConclusionThis study supports the hypothesis that a history of migraine is associated with a lower risk of breast cancer and that this relationship is independent of recent NSAID use.