LACTATION AND A REDUCED RISK OF PREMENOPAUSAL BREAST-CANCER
LACTATION AND A REDUCED RISK OF PREMENOPAUSAL BREAST-CANCER
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DOI：
10.1056/nejm199401133300201
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发表时间：
1994-01-13
影响因子：
158.5
通讯作者：
MACMAHON, B
中科院分区：
文献类型：
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作者：
NEWCOMB, PA;STORER, BE;MACMAHON, B
背景哺乳与女性乳腺癌风险降低相关的证据有限且不一致。哺乳的影响似乎仅限于绝经前有长期哺乳史的妇女，但大多数关于这种关系的研究在统计学上都很有限。我们进行了一项多中心、以人群为基础的病例对照研究，样本量足够大，我们可以更精确地描述哺乳与乳腺癌风险之间的关系。从威斯康星州、马萨诸塞州、缅因州和新罕布什尔州的全州肿瘤登记处确定了75岁以下的乳腺癌患者。对照组是从有执照的司机名单中随机选择的，如果病例受试者年龄小于65岁，则从医疗保险受益人名单中随机选择，如果他们年龄在65岁到74岁之间。通过电话访谈获得哺乳、生殖史、家族史和病史等信息。排除未生育妇女后，保留5878例病例和8216例对照进行分析。在调整了产次、初产年龄和其他乳腺癌危险因素后，与经产但从未哺乳的妇女相比，哺乳与绝经前妇女乳腺癌风险的轻微降低有关（相对危险度，0.78; 95%置信区间，0.66 - 0.91）;绝经后妇女哺乳与未哺乳相比，乳腺癌的相对危险度为1.04（95%置信区间，0.95 - 1.14）。随着哺乳期累积时间的增加，绝经前妇女患乳腺癌的风险降低（P <0.05）。
Background. The evidence of an association of lactation with a reduction in the risk of breast cancer among women has been limited and inconsistent. The effect of lactation appears to be confined to premenopausal women with a history of long lactation, but most studies of this relation have been limited in statistical power. We conducted a multicenter, population-based, case-control study with a sample large enough for us to describe more precisely the association between lactation and the risk of breast cancer.Methods. Patients less than 75 years old who had breast cancer were identified from statewide tumor registries in Wisconsin, Massachusetts, Maine, and New Hampshire. Controls were randomly selected from lists of licensed drivers if the case subjects were less than 65 years old, and from lists of Medicare beneficiaries if they were 65 through 74 years old. Information on lactation, reproductive history, and family and medical history was obtained by means of telephone interviews. After the exclusion of nulliparous women, 5878 case subjects and 8216 controls remained for analysis.Results. After adjustment for parity, age at first delivery, and other risk factors for breast cancer, lactation was associated with a slight reduction in the risk of breast cancer among premenopausal women, as compared with the risk among women who were parous but had never lactated (relative risk, 0.78; 95 percent confidence interval, 0.66 to 0.91); the relative risk of breast cancer among postmenopausal women who had lactated, as compared with those who had not, was 1.04 (95 percent confidence interval, 0.95 to 1.14). With an increasing cumulative duration of lactation, there was a decreasing risk of breast cancer among premenopausal women (P for trend