Epidemiology of basal-like breast cancer
Epidemiology of basal-like breast cancer
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DOI：
10.1007/s10549-007-9632-6
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发表时间：
2008-05-01
影响因子：
3.8
通讯作者：
Perou, Charles M.
中科院分区：
文献类型：
--
作者：
Millikan, Robert C.;Newman, Beth;Perou, Charles M.
卡罗莱纳乳腺癌研究确定了新发现的“内在”乳腺癌亚型（管腔型A、管腔型B、基底样和人表皮生长因子受体2阳性/雌激素受体阴性）的危险因素，这是一项针对非洲裔美国人和白色女性的基于人群的病例对照研究。免疫组织化学标记物被用于对1,424例浸润性和原位乳腺癌进行亚型分析，并将病例亚型与2,022例对照进行比较。Luminal A是最常见的亚型，在以前的研究中表现出典型的乳腺癌风险因素，包括增加产次和首次足月妊娠时年龄较小的负相关性。基底样病例表现出与管腔A相反的几种相关性，包括第一次足月妊娠时产次和年龄较小的风险增加。母乳喂养时间延长、母乳喂养儿童数量增加、每个儿童母乳喂养月数增加均与基底细胞样乳腺癌风险降低相关，但与管腔型A型乳腺癌无关。未进行母乳喂养的多胎活产妇女和使用药物抑制哺乳的妇女患基底样乳腺癌的风险增加，但不是管腔A型乳腺癌。腰臀比升高与绝经后妇女中管腔A的风险增加有关，与绝经前和绝经后妇女中基底样乳腺癌的风险增加有关。绝经前非洲裔美国妇女基底细胞样乳腺癌的患病率最高，她们也表现出基底细胞样危险因素的最高患病率。在年轻的非洲裔美国妇女中，我们估计高达68%的基底样乳腺癌可以通过促进母乳喂养和减少腹部肥胖来预防。
Risk factors for the newly identified "intrinsic" breast cancer subtypes (luminal A, luminal B, basal-like and human epidermal growth factor receptor 2-positive/estrogen receptor-negative) were determined in the Carolina Breast Cancer Study, a population-based, case-control study of African-American and white women. Immunohistochemical markers were used to subtype 1,424 cases of invasive and in situ breast cancer, and case subtypes were compared to 2,022 controls. Luminal A, the most common subtype, exhibited risk factors typically reported for breast cancer in previous studies, including inverse associations for increased parity and younger age at first full-term pregnancy. Basal-like cases exhibited several associations that were opposite to those observed for luminal A, including increased risk for parity and younger age at first term full-term pregnancy. Longer duration breastfeeding, increasing number of children breastfed, and increasing number of months breastfeeding per child were each associated with reduced risk of basal-like breast cancer, but not luminal A. Women with multiple live births who did not breastfeed and women who used medications to suppress lactation were at increased risk of basal-like, but not luminal A, breast cancer. Elevated waist-hip ratio was associated with increased risk of luminal A in postmenopausal women, and increased risk of basal-like breast cancer in pre- and postmenopausal women. The prevalence of basal-like breast cancer was highest among premenopausal African-American women, who also showed the highest prevalence of basal-like risk factors. Among younger African-American women, we estimate that up to 68% of basal-like breast cancer could be prevented by promoting breastfeeding and reducing abdominal adiposity.