Role and impact of menstrual and reproductive factors on breast cancer risk in Japan
Role and impact of menstrual and reproductive factors on breast cancer risk in Japan
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DOI：
10.1097/01.cej.0000228410.14095.2d
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发表时间：
2007-04-01
影响因子：
2.4
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
--
作者：
Iwasaki, Motoki;Otani, Tetsuya;Tsugane, Shoichiro
本研究的目的是阐明月经和生殖因素与乳腺癌及其激素受体定义的亚型相关的作用和影响，使用日本公共卫生中心前瞻性研究的数据，在低风险人群中的绝经前和绝经后妇女中进行整体和单独研究。共55537名40-69岁的妇女完成了自填式问卷，其中包括月经和生育史的项目。在1990-2002年期间，发现了441例新诊断的乳腺癌病例。绝经前妇女初潮年龄早，自然绝经年龄晚，绝经前和绝经后妇女未产和低产次，绝经后妇女初次生育年龄晚与乳腺癌风险增加显著相关。使用外源性女性激素或母乳喂养与乳腺癌风险之间没有总体显着关联。月经初潮年龄和自然绝经年龄与孕激素受体阴性乳腺癌的风险比阳性乳腺癌的风险更密切相关，尽管雌激素受体状态没有观察到差异。激素受体定义的乳腺癌与产次、分娩次数和首次生育年龄相关的风险没有显著差异。我们的研究结果表明，月经和生殖因素可能在低风险人群中乳腺癌的发展中发挥重要作用，与西方人群相似，并且风险因素可能因激素受体状态而异。
The aim of this study was to clarify the role and impact of menstrual and reproductive factors in relation to breast cancer and its hormone receptor-defined subtype, overall and separately among premenopausal and postmenopausal women in a low-risk population, using data from the Japan Public Health Center-based Prospective study. A total of 55537 women aged 40-69 years completed a self-administered questionnaire, which included items about menstrual and reproductive history. During 1990-2002, 441 newly diagnosed cases of breast cancer were identified. Early age at menarche for premenopausal women, late age at natural menopause, nulliparity and low parity for both premenopausal and postmenopausal women, and late age at first birth for postmenopausal women were significantly associated with an increased risk of breast cancer. No overall significant associations were seen between the use of exogenous female hormones or breast feeding and breast cancer risk. Age at menarche and age at natural menopause were somewhat more closely associated with the risk of progesterone receptor-negative than positive breast cancer although no difference was observed for estrogen receptor status. Risks associated with parity, number of births and age at first birth did not significantly differ by hormone receptor-defined breast cancer. Our findings suggest that menstrual and reproductive factors may play an important role in the development of breast cancer among low-risk populations, similarly as they do in Western populations, and that risk factors might differ by hormone receptor status.