Risk factors for breast cancer in women with a breast cancer family history.
Risk factors for breast cancer in women with a breast cancer family history.
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发表时间：
1998-05
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通讯作者：
K. Egan;M. Stampfer;B. Rosner;D. Trichopoulos;P. A. Newcomb;A. Trentham-Dietz;M. P. Longnecker;R. Mittendorf;E. Greenberg;Walter C. Willett
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作者：
K. Egan;M. Stampfer;B. Rosner;D. Trichopoulos;P. A. Newcomb;A. Trentham-Dietz;M. P. Longnecker;R. Mittendorf;E. Greenberg;Walter C. Willett
家族史（FH）是女性未来患乳腺癌风险的重要指标。利用一项大型人群病例对照研究（6705例和9341例对照）收集的数据，我们在报告患有一级FH的妇女（母亲或姐妹）中检查了乳腺癌与已知危险因素的关系，重点是可以改变生活方式决定因素以降低风险。18.4% （n = 1234）的病例报告了一级FH， 11.3% （n = 1058）的对照组报告了一级FH；阳性病史相关的乳腺癌总体相对危险度（RR）为1.70[95%可信区间（CI）， 1.55-1.87]， 45岁及以下乳腺癌的总体相对危险度（RR）为2.34 （95% CI, 1.80-3.02）。在患有FH的女性中，观察到胎次增加（每次分娩的RR = 0.90； P 2000 IU/天= 0.73;P = 0.02）和年轻时剧烈运动（每次发作/周的RR = 0.93; P = 0.02）具有统计学意义的负相关。最近饮酒增加了风险（每13克/周的相对危险度= 1.21;P = 0.02），绝经后妇女成年后体重增加也增加了风险（每5公斤的相对危险度= 1.08;P = 0.001）。任何时间的母乳喂养都与已分娩、绝经前妇女的低RR相关（RR = 0.59; P = 0.04）。大多数与乳腺癌相关的危险因素在有和没有乳腺癌FH的妇女中是相似的；然而，在有阳性病史的女性中，观察到胎次有更强的负相关（交互作用P = 0.04）。基于这些数据，FH妇女可以通过调整生活方式和生育选择来降低患乳腺癌的过度风险。与FH相关的乳腺癌风险似乎在很大程度上独立于其他已知的风险因素。
Family history (FH) is an important indicator of a woman's future risk of developing breast cancer. Using data collected in a large population-based case-control study (6705 cases and 9341 controls), we examined the associations of breast cancer with known risk factors in women reporting a first-degree FH (mother or sister), with an emphasis on lifestyle determinants that may be altered to reduce risk. First-degree FH was reported by 18.4% (n = 1234) of cases and 11.3% (n = 1058) of controls; the overall relative risk (RR) for breast cancer associated with a positive history was 1.70 [95% confidence interval (CI), 1.55-1.87] and 2.34 (95% CI, 1.80-3.02) for breast cancer at age 45 years or younger. Among women with a FH, statistically significant inverse associations were observed for increasing parity (RR per birth = 0.90; P 2000 IU/day = 0.73; P = 0.02), and strenuous activity as a young adult (RR per episode/week = 0.93; P = 0.02). Recent alcohol consumption increased risk (RR per 13 g/week = 1.21; P = 0.02), as did weight gain during adult life in postmenopausal women (RR per 5 kg = 1.08; P = 0.001). Breast-feeding for any duration was associated with a lower RR in parous, premenopausal women (RR = 0.59; P = 0.04). Associations for most risk factors with breast cancer were similar among women with and without a FH of breast cancer; however, a stronger inverse association was observed for parity in women with a positive history (P for interaction = 0.04). Based on these data, women with a FH may reduce their excess risk of breast cancer through adjustments in lifestyle and reproductive choices. The risk associated with FH of breast cancer seems to be largely independent of other known risk factors.