High constant incidence in twins and other relatives of women with breast cancer
High constant incidence in twins and other relatives of women with breast cancer
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DOI：
10.1038/82533
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发表时间：
2000-12-01
期刊：
影响因子：
30.8
通讯作者：
Mack, TM
中科院分区：
文献类型：
--
作者：
Peto, J;Mack, TM
乳腺癌的发病率在25岁至50岁之间急剧上升，此后缓慢上升。相比之下，乳腺癌女性未受影响（对侧）乳房的发病率在诊断后至少未来20年内保持不变，每年约为0.7%，与首次诊断时的年龄无关。患者亲属的发病率似乎显示出类似的模式。在一项对患者的单卵双胞胎进行的前瞻性研究中，发病率约为每年1.3%（77例），每个乳房约为0.7%。在年龄大于患者诊断年龄时，其母亲和姐妹篇的发病率为每年0.3-0.4%。高于患者诊断时的年龄，亲属中的比率没有显示出时间趋势，并且与患者诊断时的年龄无关。一个统计学上简单的解释是，易感妇女的发病率在家庭之间不同的预定年龄增加到一个高的恒定水平，但这似乎与传统的致癌和易感性模型不一致。单卵双胞胎患者的发病率非常高，表明乳腺癌的高比例，也许是大多数，发生在易感的少数妇女中。
The incidence of breast cancer rises steeply between ages 25 and 50, and more slowly thereafter. In contrast, the incidence in the unaffected (contralateral) breast of women who have had breast cancer remains constant at about 0.7% per year for at least the next 20 years after diagnosis, irrespective of age at first diagnosis. The incidence in relatives of the patients seems to show a similar pattern. The incidence in a prospective study of monozygotic twins of patients was approximately constant at 1.3% per year (77 cases), again about 0.7% per breast. At ages older than a patient's age at diagnosis, her mother and sisters have an incidence of 0.3-0.4% per year. Above the index patient's age at diagnosis, the rate in relatives shows no temporal trend and is independent of the patient's age at diagnosis. A statistically simple explanation is that incidence in susceptible women increases to a high constant level by a predetermined age that varies between families, but this seems inconsistent with conventional models of carcinogenesis and susceptibility. The very high incidence in monozygotic twins of patients indicates that a high proportion, and perhaps the majority, of breast cancers arise in a susceptible minority of women.