Reproductive factors and histologic subtype in relation to mortality after a breast cancer diagnosis.
Reproductive factors and histologic subtype in relation to mortality after a breast cancer diagnosis.
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DOI：
10.1007/s10549-011-1666-0
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发表时间：
2011-12
影响因子：
3.8
通讯作者：
Trentham-Dietz, A.
中科院分区：
文献类型：
--
作者：
Andersen, S. Warren;Newcomb, P. A.;Hampton, J. M.;Titus-Ernstoff, L.;Egan, K. M.;Trentham-Dietz, A.
有证据表明，某些生殖因素与小叶乳腺癌的发病率比与导管乳腺癌的发病率有更强的相关性。影响乳腺癌发病组织学的机制也可能影响生存率。1986-2005年间诊断为浸润性乳腺癌(N=22,302)的妇女参加了美国三个州的一系列以人群为基础的研究。参与者完成了关于生殖暴露和其他乳腺癌风险因素的电话采访。组织学亚型来自州癌症登记处。截至2006年12月，使用国家死亡指数确定了生命状况和死因。女性被跟踪调查的平均时间为9.8年，有记录的乳腺癌死亡人数为3050人。调整后的风险比(HR)和95%可信区间(95%CI)是通过COX比例风险回归模型计算出来的。产次与乳腺癌特异性死亡率呈负相关(P趋势=0.002)。尽管全因死亡率的相关性减弱，但相关性相似。在被诊断为导管乳腺癌的妇女中，观察到有五个或更多孩子的妇女与没有孩子的妇女相比，乳腺癌特异性死亡率降低了15%(HR=0.85，95%CI：0.73-1.00)。在小叶亚型的女性中也观察到了类似的相反但不显著的关联(HR=0.70，95%CI：0.43-1.14)。这一趋势并未延伸到导管-小叶混合型乳腺癌。初次出生的年龄与乳腺癌特异性或全因死亡率没有一致的关系。我们发现，增加产次可以降低导管和小叶性乳腺癌的死亡率。足月出生的人数，而不是第一次出生的年龄，对乳腺癌特有的死亡率和总体死亡率都有影响。
Evidence suggests that certain reproductive factors are more strongly associated with the incidence of lobular than of ductal breast cancer. The mechanisms influencing breast cancer incidence histology may also affect survival. Women with invasive breast cancer (N = 22,302) diagnosed during 1986–2005 were enrolled in a series of population-based studies in three US states. Participants completed telephone interviews regarding reproductive exposures and other breast cancer risk factors. Histologic subtype was obtained from state cancer registries. Vital status and cause of death were determined through December 2006 using the National Death Index. Women were followed for 9.8 years on average with 3,050 breast cancer deaths documented. Adjusted hazard rate ratios (HR) and 95% confidence intervals (95% CI) were calculated using Cox proportional hazards regression models for breast cancer-specific and all-cause mortality. Parity was inversely associated with breast cancer-specific mortality (PTrend = 0.002). Associations were similar though attenuated for all-cause mortality. In women diagnosed with ductal breast cancer, a 15% reduction in breast cancer-specific mortality was observed in women with five or more children when compared to those with no children (HR = 0.85, 95% CI: 0.73–1.00). A similar inverse though non-significant association was observed in women with lobular subtype (HR = 0.70, 95% CI: 0.43–1.14). The trend did not extend to mixed ductal–lobular breast cancer. Age at first birth had no consistent relationship with breast cancer-specific or all-cause mortality. We found increasing parity reduced mortality in ductal and lobular breast cancer. The number of full-term births, rather than age at first birth, has an effect on both breast cancer-specific and overall mortality.
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影响因子：
3.8
作者：
Schouten, LJ;Hupperets, PSGJ;Blijham, GH
通讯作者：
Blijham, GH
影响因子：
8.8
作者：
Li, CI;Uribe, DJ;Daling, JR
通讯作者：
Daling, JR
影响因子：
3.8
作者：
Trivers, Katrina F.;Gammon, Marilie D.;Coates, Ralph J.
通讯作者：
Coates, Ralph J.
绝经前乳腺癌的体型和生存。
影响因子：
8.8
作者：
Greenberg, E R;Vessey, M P;McPherson, K;Doll, R;Yeates, D
通讯作者：
Yeates, D
影响因子：
7.2
作者：
Whiteman, MK;Hillis, SD;Marchbanks, PA
通讯作者：
Marchbanks, PA