A Review of Modifiable Risk Factors in Young Women for the Prevention of Breast Cancer.
A Review of Modifiable Risk Factors in Young Women for the Prevention of Breast Cancer.
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DOI：
10.2147/bctt.s268401
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Copson ER
中科院分区：
文献类型：
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作者：
Daly AA;Rolph R;Cutress RI;Copson ER
乳腺癌是40岁以下女性最常见的癌症诊断，也是这一年龄段癌症死亡的第二大常见原因。在过去的二十年里，全球年轻乳腺癌发病率稳步上升。尽管年轻女性乳腺癌患者的高外显性乳腺癌易感基因(CSG)潜在致病突变的频率高于老年女性，但绝大多数年轻乳腺癌患者并未发现种系CSG突变。因此，有必要让年轻妇女了解非遗传性乳腺癌风险因素，这些因素有可能受到个人行为变化的影响。Pubmed搜索使用搜索词“年轻”或“早发”，以及“乳腺癌”和“可修改的风险”。对同行评议出版物的标题和摘要进行了相关性筛选。这篇综述提供了年轻女性乳腺癌风险的潜在可改变的危险因素的证据，包括生活方式因素(体力活动、身体习惯、饮酒、吸烟、轮班工作和社会经济因素)、生殖和激素因素以及医源性风险。讨论了这些因素真正可改变的程度，并讨论了遗传和非遗传风险因素之间的相互作用。卫生保健专业人员有机会向年轻女性介绍乳房健康和风险，包括作为风险因素的体育活动和饮酒习惯的好处。关于个人风险和利益的更有重点的讨论应该伴随着关于生殖健康的对话，并考虑到不可改变的和医源性BC风险因素。
Breast cancer is the most common cancer diagnosis in women aged less than 40 years and the second most common cause of cancer death in this age group. Global rates of young onset breast cancer have risen steadily over the last twenty years. Although young women with breast cancer have a higher frequency of underlying pathogenic mutations in high penetrance breast cancer susceptibility genes (CSG) than older women, the vast majority of young breast cancer patients are not found to have a germline CSG mutation. There is therefore a need to inform young women regarding non-genetic breast cancer risk factors which have the potential to be influenced by changes in individual behaviour. A Pubmed search was performed using the search terms “young” or “early onset”, and “breast cancer” and “modifiable risk”. Titles and abstracts from peer-reviewed publications were screened for relevance. This review presents evidence for potentially modifiable risk factors of breast cancer risk in young women, including lifestyle factors (physical activity, body habitus, alcohol use, smoking, shift work and socioeconomic factors), reproductive and hormonal factors and iatrogenic risks. The extent to which these factors are truly modifiable is discussed and interactions between genetic and non-genetic risk factors are also addressed. Health care professionals have an opportunity to inform young women about breast health and risk when presenting at a “teachable moment”, including the benefits of physical activity and alcohol habits as risk factor. More focussed discussions regarding individual personal risk and benefit should accompany conversations regarding reproductive health and take into consideration both non-modifiable and iatrogenic BC risk factors.