Prenatal and perinatal correlates of adult mammographic breast density
Prenatal and perinatal correlates of adult mammographic breast density
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DOI：
10.1158/1055-9965.epi-04-0762
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发表时间：
2005-06-01
影响因子：
3.8
通讯作者：
Vachon, CM
中科院分区：
文献类型：
--
作者：
Cerhan, JR;Sellers, TA;Vachon, CM
背景：成人乳腺摄影密度百分比是已知的乳腺癌最强的危险因素之一。在子宫内暴露于高水平的内源性雌激素（或其他妊娠激素）已被假设为增加乳腺癌的风险在以后的生活。我们研究的假设，这些因素与较高水平的雌激素在怀孕期间或出生后不久，与较高的乳房摄影乳腺density在adult.Methods：我们分析了数据的1,893名妇女从360个家庭在明尼苏达州乳腺癌家族研究谁有筛查乳房X线照片，危险因素数据，年龄超过40岁，没有乳腺癌的历史。产前和围产期的危险因素数据，确定使用邮寄问卷。使用计算机辅助阈值程序Cumulus从内外斜位视图估计乳腺摄影百分比密度和致密区域。采用线性混合效应模型，将家族相关性，以评估相关的危险因素与密度百分比，调整年龄，体重，和其他乳腺癌的危险因素，所有的时间mammography.Results：在乳房X光检查的平均年龄为60.4岁（范围，40-91岁），和76%的绝经后。在绝经后妇女中，出生体重与密度百分比呈正相关（P趋势< 0.01），≥ 3.75 kg的校正平均密度百分比为17.1%< 2.95 kg versus 21.0% for >。与胎龄呈提示性正相关（早产的平均百分比密度为16.7%，足月分娩为20.2%，晚期分娩为23.0%; P趋势= 0.07），母体子痫/先兆子痫（平均百分比密度为19.9%（否）和14.6%（是）; P = 0.16），婴儿时母乳喂养（从未和永远的平均百分比密度分别为18.2%和20.0%; P = 0.08）。没有关联的百分比密度与母亲的年龄，出生顺序，母亲使用酒精或香烟，或新生儿黄疸。除了母乳喂养，这些关联在绝经前妇女中显示出相似但减弱的趋势，尽管没有统计学意义。致密区域的结果与密度百分比结果一致。胎龄和母乳喂养的婴儿与密度百分比衰减的关联时，包括在同一模型中作为birthweight.Conclusions：体重与乳腺摄影乳腺密度和致密区绝经后妇女和绝经前妇女之间的弱，这表明它可能是一个标记，这早期的生活暴露。这些结果为妊娠雌激素或其他妊娠变化可能在乳腺癌病因学中发挥作用的假设提供了一些支持，并表明这些因素可能部分通过对乳腺密度的长期影响起作用。
Background: Adult mammographic percent density is one of the strongest known risk factors for breast cancer. In utero exposure to high levels of endogenous estrogens (or other pregnancy hormones) has been hypothesized to increase breast cancer risk in later life. We examined the hypothesis that those factors associated with higher levels of estrogen during pregnancy or shortly after birth are associated with higher mammographic breast density in adulthood.Methods: We analyzed data on 1,893 women from 360 families in the Minnesota Breast Cancer Family Study who had screening mammograms, risk factor data, over age 40, and no history of breast cancer. Prenatal and perinatal risk factor data were ascertained using a mailed questionnaire. Mammographic percent density and dense area were estimated from the mediolateral oblique view using Cumulus, a computer-assisted thresholding program. Linear mixed effects models incorporating familial correlation were used to assess the association of risk factors with percent density, adjusting for age, weight, and other breast cancer risk factors, all at time of mammography.Results: The mean age at mammography was 60.4 years (range, 40-91 years), and 76% were postmenopausal. Among postmenopausal women, there was a positive association of birthweight with percent density (P trend < 0.01), with an adjusted mean percent density of 17.1% for < 2.95 kg versus 21.0% for >= 3.75 kg. There were suggestive positive associations with gestational age (mean percent density of 16.7% for preterm birth, 20.2% for term birth, and 23.0% for late birth; P trend = 0.07), maternal eclampsia/preeclampsia (mean percent density of 19.9% for no and 14.6% for yes; P = 0.16), and being breast-fed as an infant (mean percent density of 18.2% for never and 20.0% forever; P = 0.08). There was no association of percent density with maternal age, birth order, maternal use of alcohol or cigarettes, or neonatal jaundice. Except for being breast-fed, these associations showed similar but attenuated trends among premenopausal women, although none were statistically significant. The results for dense area paralleled the percent density results. The associations of gestational age and being breast-fed as an infant with percent density attenuated when included in the same model as birthweight.Conclusions: Birthweight was positively associated with mammographic breast density and dense area among postmenopausal women and more weakly among premenopausal women, suggesting that it may be a marker of this early life exposure. These results offer some support to the hypothesis that pregnancy estrogens or other pregnancy changes may play a role in breast cancer etiology, and suggest that these factors may act in part through long-term effects on breast density.