Histological type and grade of breast cancer tumors by parity, age at birth, and time since birth: a register-based study in Norway.
Histological type and grade of breast cancer tumors by parity, age at birth, and time since birth: a register-based study in Norway.
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DOI：
10.1186/1471-2407-10-226
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发表时间：
2010-05-21
期刊：
影响因子：
3.8
通讯作者：
Thoresen SØ
中科院分区：
文献类型：
--
作者：
Albrektsen G;Heuch I;Thoresen SØ
一些研究表明，生殖因素对乳腺癌组织学类型的风险有不同的影响。分娩的长期保护作用先于短期的不利影响。很少有研究探讨出生后不久诊断出的肿瘤是否具有特定的组织学特征。在目前基于登记的研究中，包括 22,867 例挪威乳腺癌病例（20-74 岁）的信息，我们检查了组织学类型（9 个类别）和肿瘤分级（2 个组合类别）是否因胎次或初生年龄而异。在 9709 名 50 岁之前确诊的女性中评估了与出生时间的关联。应用卡方检验来比较比例，而优势比（每种组织学类型与导管，或 3-4 级与 1-2 级）在多级和二元 Logistic 回归分析中进行估计。导管肿瘤是最常见的组织学类型，占所有病例的 81.4%，其次是小叶肿瘤（6.3%）和未特指癌（5.5%）。其他亚型各占病例的0.4%-1.5%。对于所有组织学类型，诊断时年龄的比例存在显着差异。粘液性肿瘤和管状肿瘤的比例随着胎次的增加而减少，而佩吉特病和髓质肿瘤在高胎次的女性中最常见。对于小叶肿瘤和未特指的癌症，随着初产年龄的增加，这种增加的趋势最为明显；在髓质和管状肿瘤方面观察到相反方向的关联。在年龄调整分析中，只有未特指的癌症和小叶肿瘤的比例随着自第一次和最后一次出生以来时间的增加而显着下降。然而，导管肿瘤和恶性肉瘤（主要是叶状肿瘤）似乎在首次分娩后 2 年内诊断出的女性中发生频率更高。在最后一次生育后 2-5 年诊断出的女性中，髓质肿瘤和佩吉特病的比例特别高。最近分娩的女性中低分化肿瘤比例较高的部分原因是年龄较小。我们的结果支持了之前的观察结果，即生殖因素对乳腺癌组织学类型的风险有不同的影响。肉瘤、髓质肿瘤以及可能的佩吉特病可能特别容易受到与妊娠相关的接触的影响。
Some studies have indicated that reproductive factors affect the risk of histological types of breast cancer differently. The long-term protective effect of a childbirth is preceded by a short-term adverse effect. Few studies have examined whether tumors diagnosed shortly after birth have specific histological characteristics. In the present register-based study, comprising information for 22,867 Norwegian breast cancer cases (20-74 years), we examined whether histological type (9 categories) and grade of tumor (2 combined categories) differed by parity or age at first birth. Associations with time since birth were evaluated among 9709 women diagnosed before age 50 years. Chi-square tests were applied for comparing proportions, whereas odds ratios (each histological type vs. ductal, or grade 3-4 vs. grade 1-2) were estimated in polytomous and binary logistic regression analyses. Ductal tumors, the most common histological type, accounted for 81.4% of all cases, followed by lobular tumors (6.3%) and unspecified carcinomas (5.5%). Other subtypes accounted for 0.4%-1.5% of the cases each. For all histological types, the proportions differed significantly by age at diagnoses. The proportion of mucinous and tubular tumors decreased with increasing parity, whereas Paget disease and medullary tumors were most common in women of high parity. An increasing trend with increasing age at first birth was most pronounced for lobular tumors and unspecified carcinomas; an association in the opposite direction was seen in relation to medullary and tubular tumors. In age-adjusted analyses, only the proportions of unspecified carcinomas and lobular tumors decreased significantly with increasing time since first and last birth. However, ductal tumors, and malignant sarcomas, mainly phyllodes tumors, seemed to occur at higher frequency in women diagnosed <2 years after first childbirth. The proportions of medullary tumors and Paget disease were particularly high among women diagnosed 2-5 years after last birth. The high proportion of poorly differentiated tumors in women with a recent childbirth was partly explained by young age. Our results support previous observations that reproductive factors affect the risk of histological types of breast cancer differently. Sarcomas, medullary tumors, and possible also Paget disease, may be particularly susceptible to pregnancy-related exposure.
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影响因子：
1.1
作者：
ERDREICH, LS;ASAL, NR;HOGE, AF
通讯作者：
HOGE, AF
影响因子：
6.2
作者：
BORDEN, EC;BALKWILL, FR
通讯作者：
BALKWILL, FR
影响因子：
6
作者：
McDaniel, SM;Rumer, KK;Schedin, P
通讯作者：
Schedin, P
影响因子：
3.8
作者：
Albrektsen, G;Heuch, I;Kvåle, G
通讯作者：
Kvåle, G
影响因子：
3.4
作者：
Ibrahim, EM;Ezzat, AA;Mohammed, GH
通讯作者：
Mohammed, GH