History of uterine leiomyomata and incidence of breast cancer.
History of uterine leiomyomata and incidence of breast cancer.
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DOI：
10.1007/s10552-015-0647-8
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Palmer JR
中科院分区：
文献类型：
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作者：
Wise LA;Radin RG;Rosenberg L;Adams-Campbell L;Palmer JR
子宫平滑肌瘤（UL），子宫肌层的良性肿瘤，受到性类固醇激素的影响。UL诊断史与子宫恶性肿瘤的高风险相关。UL和乳腺癌（另一种对乳腺癌有反应的癌症）之间的关系尚未研究。我们在黑人妇女健康研究（一项前瞻性队列研究）中调查了自我报告的医生诊断的UL与乳腺癌发病率之间的关系。我们从1995年到2013年跟踪了57，747名没有乳腺癌病史的参与者。UL诊断在基线和每两年报告一次。乳腺癌在两年一次的问卷调查中报告，并通过医疗记录或癌症登记处的病理学数据证实。使用考克斯回归推导发生率比（IRR）和95%置信区间（CI），并调整潜在混杂因素。在879,672人年的随访中，有2,276例乳腺癌（1,699例浸润性，394例原位，183例未知）。UL病史与乳腺癌发病率之间总体相关性的多变量IRR为0.99（95% CI：0.90-1.08），ER+（IRR=1.03）和ER−乳腺癌（IRR=1.05）的结果相似。UL早期诊断（30岁之前）的IRR略高于1.0，总体乳腺癌的IRR为1.14（95% CI：0.99-1.31），ER+乳腺癌为1.14（95% CI：0.93-1.40），ER−乳腺癌为1.20（95% CI：0.89-1.61）。对于40岁之前诊断的乳腺癌（IRR=1.39，95% CI：0.97-1.99）和绝经前乳腺癌（IRR=1.26，95% CI：1.01-1.58），UL早期诊断的IRR升高。在雌激素受体亚型之间没有观察到一致的风险模式，并且在BMI、女性激素使用、乳房X线摄影术近期或乳腺癌家族史的分层中，IRR没有明显差异。目前对美国黑人妇女的研究表明，UL诊断史与乳腺癌的总体发病率无关。早期诊断的UL与40岁以前的乳腺癌和绝经前乳腺癌的正相关性需要在未来的研究中得到证实。
Uterine leiomyomata (UL), benign tumors of the myometrium, are influenced by sex steroid hormones. A history of UL diagnosis has been associated with a higher risk of uterine malignancies. The relation between UL and breast cancer, another hormonally-responsive cancer, has not been studied. We investigated the association between self-reported physician-diagnosed UL and incidence of breast cancer in the Black Women's Health Study, a prospective cohort study. We followed 57,747 participants without a history of breast cancer from 1995 to 2013. UL diagnoses were reported at baseline and biennially. Breast cancer was reported on biennial questionnaires and confirmed by pathology data from medical records or cancer registries. Cox regression was used to derive incidence rate ratios (IRRs) and 95% confidence intervals (CI) and adjust for potential confounders. There were 2,276 incident cases of breast cancer (1,699 invasive, 394 in situ, and 183 unknown) during 879,672 person-years of follow-up. The multivariable IRR for the overall association between history of UL and breast cancer incidence was 0.99 (95% CI: 0.90-1.08), with similar results for ER+ (IRR=1.03) and ER− breast cancer (IRR=1.05). IRRs for early diagnosis of UL (before age 30) were slightly above 1.0, with IRRs of 1.14 (95% CI: 0.99-1.31) for overall breast cancer, 1.14 (95% CI: 0.93-1.40) for ER+ breast cancer, and 1.20 (95% CI: 0.89-1.61) for ER− breast cancer. IRRs for early diagnosis of UL were elevated for breast cancer diagnosed before age 40 years (IRR=1.39, 95% CI: 0.97-1.99) and premenopausal breast cancer (IRR=1.26, 95% CI: 1.01-1.58). No consistent patterns in risk were observed across estrogen receptor subtypes, and IRRs did not differ appreciably within strata of BMI, female hormone use, mammography recency, or family history of breast cancer. The present study of U.S. black women suggests that a history of UL diagnosis is unrelated to the incidence of breast cancer overall. The positive associations observed for early-diagnosed UL with breast cancer before age 40 and with premenopausal breast cancer require confirmation in future studies.