Circulating Sex Hormones and Mammographic Breast Density among Postmenopausal Women
Circulating Sex Hormones and Mammographic Breast Density among Postmenopausal Women
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DOI：
10.1007/s12672-010-0056-0
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发表时间：
2011-02-01
影响因子：
3
通讯作者：
Sisney, Gale S.
中科院分区：
文献类型：
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作者：
Sprague, Brian L.;Trentham-Dietz, Amy;Sisney, Gale S.
乳腺密度作为乳腺癌风险的中间或预测标志物的使用受到对乳腺密度病因学不完全理解的限制。高水平的内源性雌激素和雄激素与绝经后妇女乳腺癌的风险增加有关。我们试图研究这些激素是否也与乳房密度有关。威斯康星州乳腺密度研究从威斯康星州麦迪逊的乳腺X线摄影诊所招募了257名绝经后妇女，年龄55-70岁，无绝经后激素使用史。受试者提供了用于性激素分析的血液样本，并使用计算机辅助阈值方法从受试者的筛查乳房X线照片中测量乳房密度。在年龄调整分析中，许多性激素与乳腺密度相关。然而，进一步调整体重指数和其他潜在的混杂因素大大减弱或消除了这些关联。在完全校正的模型中，乳腺密度百分比与血清孕酮之间仍存在正相关（P=0.03），血清孕酮最低四分位数女性的乳腺密度百分比从11.9%（95% CI：9.8，14.1%）上升至最高四分位数女性的15.4%（12.9，18.2%）。性激素结合球蛋白与乳腺密度百分比也呈正相关（P=0.06）。相比之下，乳腺密度百分比与雌二醇（总、游离或生物可利用）、雌酮、硫酸雌酮或睾酮（总、游离或生物可利用）之间没有独立关联。这些结果表明，乳腺密度有激素病因，但它可能在重要方面不同于乳腺癌的风险。
The use of breast density as an intermediate or predictive marker of breast cancer risk is limited by an incomplete understanding of the etiology of breast density. High blood levels of endogenous estrogens and androgens are associated with increased risk of breast cancer among postmenopausal women. We sought to examine whether these hormones are also associated with breast density. The Wisconsin Breast Density Study enrolled 257 postmenopausal women, ages 55-70 years, with no history of postmenopausal hormone use, from mammography clinics in Madison, Wisconsin. Subjects provided a blood sample for sex hormone analysis, and breast density was measured from subjects' screening mammograms using a computer-assisted thresholding method. Numerous sex hormones were associated with breast density in age-adjusted analyses. However, further adjustment for body mass index and other potentially confounding factors substantially attenuated or eliminated these associations. In the fully adjusted model, there remained a positive association between percent breast density and serum progesterone (P=0.03), with percent density rising from 11.9% (95% CI: 9.8, 14.1%) among women in the lowest quartile of serum progesterone to 15.4% (12.9, 18.2%) among women in the highest quartile. There was also a positive association between sex hormone binding globulin and percent breast density (P=0.06). In contrast, there were no independent associations between percent breast density and estradiol (total, free, or bioavailable), estrone, estrone sulfate, or testosterone (total, free, or bioavailable). These results suggest that breast density has a hormonal etiology; however, it may differ in important ways from that of breast cancer risk.