Importance of hereditary and selected environmental risk factors in the etiology of inflammatory breast cancer: a case-comparison study.
Importance of hereditary and selected environmental risk factors in the etiology of inflammatory breast cancer: a case-comparison study.
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DOI：
10.1186/s12885-016-2369-z
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发表时间：
2016-05-26
期刊：
影响因子：
3.8
通讯作者：
Levine PH
中科院分区：
文献类型：
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作者：
Moslehi R;Freedman E;Zeinomar N;Veneroso C;Levine PH
为了评估遗传在炎性乳腺癌（IBC）病因中的重要性，我们就乳腺癌一级家族病史的患病率，将IBC患者与几个精心挑选的对照组进行了比较。
将IBC病例（n = 141）与通过乔治·华盛顿大学（GWU）确定的非炎性乳腺癌病例（n = 178）就乳腺癌一级家族病史的患病率以及选定的乳腺癌环境/生活方式风险因素进行了比较。还与来自三项病例对照研究的受试者进行了类似的比较：来自癌症易感性遗传标记（CGEMS）研究的乳腺癌病例（n = 1145）和未患病对照（n = 1142），来自妇女健康倡议（WHI）研究的乳腺癌病例（n = 465）和对照（n = 9317），以及来自多伦多大学（UT）一项研究的卵巢癌病例（n = 260）和对照（n = 331）。
IBC病例中乳腺癌一级家族病史的频率为17.0%，而GWU乳腺癌病例为24.4%，CGEMS乳腺癌病例和对照分别为23.9%和17.9%，WHI乳腺癌病例和对照分别为16.9%和12.6%，UT卵巢癌病例和对照分别为24.2%和11.2%。
IBC病例中经产妇女的患病率明显低于WHI乳腺癌病例（比值比 = 0.46，95%置信区间：0.27 - 0.81）和对照（比值比 = 0.31，95%置信区间：0.20 - 0.49）。与WHI乳腺癌病例（比值比 = 7.77，95%置信区间：4.82 - 12.59）和对照（比值比 = 8.14，95%置信区间：5.28 - 12.61）相比，IBC病例中口服避孕药的使用率明显更高。与WHI对照（比值比 = 1.84，95%置信区间：1.20 - 2.82）和UT对照（比值比 = 1.86，95%置信区间：1.07 - 3.22）相比，IBC病例经常饮酒（每天≥1杯）的频率明显更高，并且与GWU（18.2%）和WHI（15.2%）的乳腺癌病例相比，其患病率（21.3%）更高（无统计学意义）。
IBC病例中乳腺癌一级家族病史的患病率低于乳腺癌和卵巢癌病例，但高于未患病个体。我们的多病例炎性和非炎性乳腺癌家族可能反映了导致两种类型乳腺癌的常见遗传和/或环境因素的聚集。我们关于口服避孕药使用和经常饮酒可能与IBC相关的发现值得进一步研究。
To assess the importance of heredity in the etiology of inflammatory breast cancer (IBC), we compared IBC patients to several carefully chosen comparison groups with respect to the prevalence of first-degree family history of breast cancer. IBC cases (n = 141) were compared to non-inflammatory breast cancer cases (n = 178) ascertained through George Washington University (GWU) with respect to the prevalence of first-degree family history of breast cancer and selected environmental/lifestyle risk factors for breast cancer. Similar comparisons were conducted with subjects from three case–control studies: breast cancer cases (n = 1145) and unaffected controls (n = 1142) from the Cancer Genetic Markers of Susceptibility (CGEMS) study, breast cancer cases (n = 465) and controls (n = 9317) from the Women’s Health Initiative (WHI) study, and ovarian cancer cases (n = 260) and controls (n = 331) from a study by University of Toronto (UT). The frequency of first-degree breast cancer family history among IBC cases was 17.0 % compared to 24.4 % for GWU breast cancer cases, 23.9 % and 17.9 % for CGEMS breast cancer cases and controls, respectively, 16.9 % and 12.6 % for WHI breast cancer cases and controls, respectively, and 24.2 % and 11.2 % for UT ovarian cancer cases and controls, respectively. IBC cases had a significantly lower prevalence of parous women than WHI breast cancer cases (OR = 0.46, 95 % CI:0.27–0.81) and controls (OR = 0.31, 95 % CI:0.20–0.49). Oral contraceptive use was significantly higher among IBC cases compared to WHI breast cancer cases (OR = 7.77, 95 % CI:4.82–12.59) and controls (OR = 8.14, 95 % CI:5.28–12.61). IBC cases had a significantly higher frequency of regular alcohol consumption (≥1 drink per day) compared to WHI controls (OR = 1.84, 95 % CI:1.20–2.82) and UT controls (OR = 1.86, 95 % CI:1.07–3.22) and higher (statistically non-significant) prevalence (21.3 %) compared to breast cancer cases from GWU (18.2 %) and WHI (15.2 %). The prevalence of first-degree breast cancer family history among IBC cases was lower compared to breast and ovarian cancer cases but higher than unaffected individuals. Our multiple-case inflammatory and non-inflammatory breast cancer families may reflect aggregation of common genetic and/or environmental factors predisposing to both types of breast cancer. Our findings that oral contraceptive use and regular alcohol consumption may be associated with IBC warrant further investigations.