Obstetric history and mammographic density: a population-based cross-sectional study in Spain (DDM-Spain).
Obstetric history and mammographic density: a population-based cross-sectional study in Spain (DDM-Spain).
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DOI：
10.1007/s10549-011-1936-x
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发表时间：
2012-04
影响因子：
3.8
通讯作者：
Pollan, Marina
中科院分区：
文献类型：
--
作者：
Lope, Virginia;Perez-Gomez, Beatriz;Sanchez-Contador, Carmen;Carmen Santamarina, Maria;Moreo, Pilar;Vidal, Carmen;Soledad Laso, Maria;Ederra, Maria;Pedraz-Pingarron, Carmen;Gonzalez-Roman, Isabel;Garcia-Lopez, Milagros;Salas-Trejo, Dolores;Peris, Merce;Pilar Moreno, Maria;Antonio Vazquez-Carrete, Jose;Collado, Francisca;Aragones, Nuria;Pollan, Marina
高乳房X线密度（MD）被用作乳腺癌表型风险标记。在怀孕和哺乳期间，乳房获得充分发育，细胞增殖，随后进入小叶分化阶段。本研究调查了绝经前和绝经后女性产科因素对 MD 的影响。我们在七个筛查中心招募了 3,574 名 45-68 岁的女性参加乳腺癌筛查项目。为了测量 MD，由经验丰富的放射科医生使用颅尾乳房 X 光检查和博伊德半定量量表进行盲法匿名读数。人口统计和生殖数据由经过专门培训的工作人员在筛选之日直接进行调查。 MD 和产科变量之间的关联通过序数逻辑回归进行量化，并引入筛查中心作为随机效应项。我们调整了年龄、孩子数量和体重指数，并按绝经状态进行了分层。胎次与密度呈负相关，每个新生儿的高 MD 概率下降 16%（P 值 < 0.001）。在经产女性中，检测到哺乳时间与哺乳时间呈正相关 [>9 个月：比值比 (OR) = 1.33； 95% 置信区间 (CI) = 1.02–1.72] 和第一个孩子的体重 (>3,500 g：OR = 1.32；95% CI = 1.12–1.54)。第一次生育的年龄对绝经前和绝经后女性表现出不同的影响（交互作用 P 值 = 0.030）。在绝经前女性中没有发现任何关联。然而，在绝经后女性中，30 岁后生第一个孩子的女性患高 MD 的概率会增加（OR = 1.53；95% CI = 1.17–2.00）。与双胞胎出生相关的较高风险也主要出现在绝经后女性中（OR = 2.02；95% CI = 1.18–3.46）。我们的研究表明，高龄第一胎母亲、怀有双胞胎的母亲、母乳喂养时间较长的母亲以及第一胎出生体重较高的母亲中，高MD的患病率更高。这些结果表明激素和生长因子对乳腺增殖活性的影响。
High mammographic density (MD) is used as a phenotype risk marker for developing breast cancer. During pregnancy and lactation the breast attains full development, with a cellular-proliferation followed by a lobular-differentiation stage. This study investigates the influence of obstetric factors on MD among pre- and post-menopausal women. We enrolled 3,574 women aged 45–68 years who were participating in breast cancer screening programmes in seven screening centers. To measure MD, blind anonymous readings were taken by an experienced radiologist, using craniocaudal mammography and Boyd’s semiquantitative scale. Demographic and reproductive data were directly surveyed by purpose-trained staff at the date of screening. The association between MD and obstetric variables was quantified by ordinal logistic regression, with screening centre introduced as a random effect term. We adjusted for age, number of children and body mass index, and stratified by menopausal status. Parity was inversely associated with density, the probability of having high MD decreased by 16% for each new birth (P value < 0.001). Among parous women, a positive association was detected with duration of lactation [>9 months: odds ratio (OR) = 1.33; 95% confidence interval (CI) = 1.02–1.72] and weight of first child (>3,500 g: OR = 1.32; 95% CI = 1.12–1.54). Age at first birth showed a different effect in pre- and post-menopausal women (P value for interaction = 0.030). No association was found among pre-menopausal women. However, in post-menopausal women the probability of having high MD increased in women who had their first child after the age of 30 (OR = 1.53; 95% CI = 1.17–2.00). A higher risk associated with birth of twins was also mainly observed in post-menopausal women (OR = 2.02; 95% CI = 1.18–3.46). Our study shows a greater prevalence of high MD in mothers of advanced age at first birth, those who had twins, those who have breastfed for longer periods, and mothers whose first child had an elevated birth weight. These results suggest the influence of hormones and growth factors over the proliferative activity of the mammary gland.
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影响因子：
2.3
作者：
Jeffreys, M;Warren, R;Smith, GD
通讯作者：
Smith, GD
影响因子：
2.3
作者：
El-Bastawissi, AY;Aiello, EJ;Taplin, SH
通讯作者：
Taplin, SH
影响因子：
6.2
作者：
HENSON, DE;TARONE, RE
通讯作者：
TARONE, RE
影响因子：
3.8
作者：
Cerhan, JR;Sellers, TA;Vachon, CM
通讯作者：
Vachon, CM
影响因子：
3.8
作者：
Greendale, Gail A.;Huang, Mei-Hua;Karlamangla, Arun
通讯作者：
Karlamangla, Arun