Breast carcinoma in situ:: Risk factors and screening patterns
Breast carcinoma in situ:: Risk factors and screening patterns
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DOI：
10.1093/jnci/93.23.1811
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发表时间：
2001-12-05
期刊：
影响因子：
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通讯作者：
Carter, D
中科院分区：
文献类型：
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作者：
Claus, EB;Stowe, M;Carter, D
背景资料：与浸润性乳腺癌相关的风险因素有很好的记录，但与乳腺原位癌相关的风险因素尚未明确。研究方法：我们在康涅狄格州的女性居民中进行了一项以人群为基础的病例对照研究，以确定乳腺原位癌的危险因素。诊断为导管原位癌（DCIS）（n = 875）或小叶原位癌（LCIS）（n = 123）的病例患者按5岁年龄组与对照组（n = 999）相匹配。病例患者在1994年9月15日至1998年3月14日期间被诊断，所有受试者的年龄在20至79岁之间。通过电话访谈收集有关风险因素和癌症筛查史的信息。条件Logistic回归用于确定这些因素与DCIS和LCIS风险相关的比值比（OR）。结果如下：DCIS病例组患者比对照组患者更可能报告乳腺癌家族史（OR 1.48; 95%置信区间[CI] 1.19 - 1.85）或既往乳腺活检（OR = 3.56; 95% CI = 2.86 - 4.43）。她们的足月妊娠率也更低（OR = 0.86; 95%CI = 0.80 - 0.93），且首次足月妊娠时年龄较大（20-29岁相对于< 20岁的OR = 1.68; 95%CI = 1.17至2.43）和绝经期（大于或等于55岁相对于< 45岁的OR = 1.71; 95%CI = 1.05至2.77）。DCIS病例患者比对照受试者更有可能进行乳房X线检查（OR = 2.46; 95% CI = 1.78至3.40）或每年进行一次临床乳房检查（OR = 1.83; 95% CI = 1.48至2.26）。DCIS患者和对照组在口服避孕药使用、激素替代治疗、饮酒或吸烟史或乳房自我检查方面没有差异。LCIS的相关性相似。结论：与DCIS和LCIS相关的危险因素与浸润性乳腺癌相关的危险因素相似。DCIS的诊断与增加乳房X线检查筛查相关。
Background: Risk factors associated with invasive breast cancer are well documented, but those associated with breast carcinoma in situ are not well defined. Methods: We conducted a population-based, case-control study among female residents of Connecticut to identify risk factors for breast carcinoma in situ. Case patients, diagnosed with ductal carcinoma in situ (DCIS) (n = 875) or lobular carcinoma in situ (LCIS) (n = 123), were matched by 5-year age groups with control subjects (n = 999). Case patients were diagnosed between September 15, 1994, through March 14, 1998, and all subjects were between the ages of 20 and 79 years. Information on risk factors and cancer-screening history was collected by telephone interviews. Conditional logistic regression was used to determine odds ratios (ORs) for the association of these factors with the risk of DCIS and LCIS. Results: Case patients with DCIS were more likely than control subjects to report a family history of breast cancer (OR 1.48; 95% confidence interval [CI] 1.19 to 1.85) or previous breast biopsy (OR = 3.56; 95% CI = 2.86 to 4.43). They also had fewer full-term pregnancies (OR = 0.86; 95% CI = 0.80 to 0.93) and were older at first full-term pregnancy (OR for being 20-29 years old relative to being < 20 years old = 1.68; 95% CI = 1.17 to 2.43) and at menopause (OR for being greater than or equal to 55 years old relative to being < 45 years old = 1.71; 95% CI = 1.05 to 2.77). DCIS case patients were more likely than control subjects to have had a mammographic examination (OR = 2.46; 95% CI = 1.78 to 3.40) or an annual clinical breast examination (OR = 1.83; 95% CI = 1.48 to 2.26). DCIS patients and control subjects did not differ with respect to oral contraceptive use, hormone replacement therapy, alcohol consumption or smoking history, or breast self-examination. Associations for LCIS were similar. Conclusions: The risk factors associated with DCIS and LCIS are similar to those associated with invasive breast cancer. Diagnosis of DCIS is associated with increased mammography screening.