Pregnancy characteristics and maternal risk of breast cancer
Pregnancy characteristics and maternal risk of breast cancer
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DOI：
10.1001/jama.294.19.2474
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发表时间：
2005-11-16
影响因子：
120.7
通讯作者：
Lambe, M
中科院分区：
文献类型：
--
作者：
Cnattingius, S;Torrång, A;Lambe, M
妊娠期间，血清雌激素、孕激素和其他激素水平明显高于生命的其他阶段。妊娠激素主要在胎盘中产生，胎盘损伤的迹象可以作为妊娠期间激素暴露的间接标志。在怀孕期间，这些标志物一直不一致地与随后的风险乳腺癌在mother.Objective检查之间的关联间接标志物的激素暴露，如胎盘重量和其他怀孕的特点，和孕产妇的风险发展为乳腺癌。设计和设置基于人群的队列研究使用的数据来自瑞典出生登记，瑞典癌症登记，瑞典死因登记，参与者：1982年至1989年期间在瑞典出生登记册上生育单胎的妇女，提供关于出生日期和胎龄的完整信息。随访妇女直至发生乳腺癌、死亡或随访结束（2001年12月31日）。考克斯比例风险模型被用来估计激素暴露和乳腺癌风险之间的关系。主要结果测量浸润性乳腺癌的发病率。在该队列的314，019名妇女中，2216名（0.7%）在2001年的随访期间患上了乳腺癌，其中2100名（95%）在50岁之前被诊断出来。与连续2次怀孕胎盘重量低于500 g的妇女相比，第一次怀孕胎盘重量在500 - 699 g之间，第二次怀孕胎盘重量至少为700 g的妇女患乳腺癌的风险增加（反之亦然）（调整后的危险比为1.82; 95%可信区间[CI]为1.07-3.08），两次妊娠中胎盘重量至少为700 g的妇女的相应风险加倍（校正风险比，2.05; 95% CI，1.15-3.64）。在调整胎盘重量和其他协变量之前，连续2次高出生体重（>= 4000 g）与乳腺癌风险增加相关，但在调整胎盘重量和其他协变量之后，与乳腺癌风险增加无关（调整后风险比，1.10; 95%CI，0.76-1.59）。这些结果进一步支持了怀孕激素是随后的母亲乳腺癌风险的重要调节剂的假设。
Context During pregnancy, serum levels of estrogen, progesterone, and other hormones are markedly higher than during other periods of life. Pregnancy hormones primarily are produced in the placenta, and signs of placental impairment may serve as indirect markers of hormone exposures during pregnancy. During pregnancy, these markers have been inconsistently associated with subsequent risk of breast cancer in the mother.Objective To examine associations between indirect markers of hormonal exposures, such as placental weight and other pregnancy characteristics, and maternal risk of developing breast cancer.Design and Setting Population-based cohort study using data from the Swedish Birth Register, the Swedish Cancer Register, the Swedish Cause of Death Register, and the Swedish Register of Population and Population Changes.Participants Women included in the Sweden Birth Register who delivered singletons between 1982 and 1989, with complete information on date of birth and gestational age. Women were followed up until the occurrence of breast cancer, death, or end of follow-up (December 31, 2001). Cox proportional hazards models were used to estimate associations between hormone exposures and risks of breast cancer.Main Outcome Measure Incidence of invasive breast cancer.Results. Of 314,019 women in the cohort, 2216 (0.7%) developed breast cancer during the follow-up through 2001, of whom 2100 (95%) were diagnosed before age 50 years. Compared with women who had placentas weighing less than 500 g in 2 consecutive pregnancies, the risk of breast cancer was increased among women whose placentas weighed between 500 and 699 g in their first pregnancy and at least 700 g in their second pregnancy (or vice versa) (adjusted hazard ratio, 1.82; 95% confidence interval [CI], 1.07-3.08), and the corresponding risk was doubled among women whose placentas weighed at least 700 g in both pregnancies (adjusted hazard ratio, 2.05; 95% Cl, 1.15-3.64). A high birth weight (>= 4000 g) in 2 successive births was associated with an increased risk of breast cancer before but not after adjusting for placental weight and other covariates (adjusted hazard ratio, 1.10; 95% Cl, 0.76-1.59).Conclusions Placental weight is positively associated with maternal risk of breast cancer. These results further support the hypothesis that pregnancy hormones are important modifiers of subsequent maternal breast cancer risk..