A study of the epidemiology of cancer of the breast. II. The influence of hysterectomy
A study of the epidemiology of cancer of the breast. II. The influence of hysterectomy
复制标题
乳腺癌流行病学研究。
作者：
T. Hirayama;E. Wynder
进行了一项研究，以调查人工绝经与乳腺癌的关系，并确定患者对有关骨盆手术类型和程度的回答的可靠性。对1954-1959年间1596例乳腺癌患者的住院病历与1573例对照进行比较。在1959-1960年间，对另外280名乳腺癌患者和280名对照组(年龄和宗教相匹配)的采访得到了医院对骨盆手术的描述的证实。结果发现，近一半的女性不知道或未能描述她们经历过的骨盆手术的正确程度。对这些数据进行分析，以确定人工绝经频率、人工绝经频率、婚姻状况、去势频率、手术类型、乳腺癌发病前的间隔时间和手术年龄。在有人工绝经史的女性中，患乳腺癌的相对风险在记录中为0.71，在访谈研究中为0.70。研究发现，在被阉割的女性中，这一风险为0.56，在未阉割的女性中，这一风险为0.86。在37岁之前被阉割的女性的风险低于0.17。结论是，这些发现与表明通过去势或停止月经来降低女性雌激素水平的结论是一致的，因为通过长期哺乳可以降低乳腺癌的发病率。这项研究揭示的乳腺癌有趣的方面应该在前瞻性研究中进行进一步的评估。
A study was undertaken to investigate the relationship of artificial menopause to breast cancer and to determine the reliability of patient response to questions about the type and extent of pelvic surgery experienced. Hospital records of 1596 breast cancer patients between 1954-1959 were compared with 1573 controls. Interviews with an additional 280 breast cancer patients and 280 controls (matched for age and religion) during 1959-1960 were substantiated by hospital descriptions of the pelvic surgery. It was found that nearly half of the women did not know or failed to relate the correct extent of pelvic surgery which they had experienced. These data were analyzed to determine frequency of artificial menopause frequency of artificial menopause by marital status frequency of castration type of operation interval before the onset of breast cancer and age at operation. The relative risk of developing breast cancer among women with a history of artificial menopause was calculated as .71 in the record and .70 in the interview study. The risk was found to be .56 among castrated women and .86 among noncastrated women. Women who were castrated prior to age 37 had a risk of less than .17. It is concluded that these findings are in agreement with those which show that reduction of the estrogen level in women through castration or cessation of menstruation as through long-term lactation will reduce the incidence of breast cancer. The interesting aspects of breast cancer revealed by the present study should undergo further evaluation in a prospective study.