Risk factors for triple-negative breast cancer in women under the age of 45 years.
Risk factors for triple-negative breast cancer in women under the age of 45 years.
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45岁以下女性三阴性乳腺癌的危险因素。
DOI：
10.1158/1055-9965.epi-08-1005
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发表时间：
2009-04
期刊：
影响因子：
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通讯作者：
Malone KE
中科院分区：
文献类型：
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作者：
Dolle JM;Daling JR;White E;Brinton LA;Doody DR;Porter PL;Malone KE
人们对三阴性乳腺癌（TNBC；ER-/PR-/HER2-）的病因学知之甚少，这是一种与高死亡率和治疗选择不足相关的乳腺癌亚型。我们开展这项研究的目的是评估 45 岁及以下女性中与人口/生活方式因素、生育史和口服避孕药 (OC) 使用相关的 TNBC 风险。研究参与者是在之前两项基于人群的病例对照研究中确定的。符合条件的病例包括西雅图-普吉特海湾地区20-45岁女性中所有原发性浸润性乳腺癌，这些女性在1983年1月至1992年12月期间诊断，获得了ER、PR和HER2状态的完整数据（n=897；包括n=187 TNBC病例）。对照者年龄匹配并通过随机数字拨号确定。使用 OC ≥1 年与 TNBC 风险增加 2.5 倍相关（95% CI 1.4-4.3），但非 TNBC 风险没有显着增加（P 异质性 0.008）。此外，较长的 OC 持续时间和较新的使用时间给 OC 用户带来的 TNBC 风险显着高于非 TNBC（P 异质性分别为 0.02 和 0.01）。在≤40岁的女性中，使用OC≥1年相关的TNBC相对风险为4.2（95% CI 1.9-9.3），而在≤40岁的女性中，使用OC不会显着增加非TNBC的风险，在41-45岁的女性中，TNBC或非TNBC的风险也没有显着增加。总之，年轻女性中 TNBC 和非 TNBC 之间的 OC 使用与乳腺癌风险之间存在显着的异质性，这为不同的病因学提供了支持。
Little is known about the etiologic profile of triple-negative breast cancer (TNBC; ER-/PR-/HER2-), a breast cancer subtype associated with high mortality and inadequate therapeutic options. We undertook the study to assess the risk of TNBC among women 45 years of age and younger in relation to demographic/lifestyle factors, reproductive history, and oral contraceptive (OC) use. Study participants were ascertained in two prior population-based, case-control studies. Eligible cases included all primary invasive breast cancers among women ages 20-45 in the Seattle-Puget Sound area, diagnosed between January 1983 and December 1992 for whom complete data was obtained for ER, PR and HER2 status (n=897; including n=187 TNBC cases). Controls were age matched and ascertained via random digit dialing. OC use ≥1 year was associated with a 2.5-fold increased risk of TNBC (95% CI 1.4-4.3) and no significantly increased risk of non-TNBC (P heterogeneity .008). Further, the risk among OC users conferred by longer OC duration and by more recent use was significantly greater for TNBC than non-TNBC (P heterogeneity .02 and .01, respectively). Among women ≤40 years, the relative risk of TNBC associated with OC use ≥1 year was 4.2 (95% CI 1.9-9.3), whereas there was no significantly increased risk with OC use for non-TNBC among women ≤40 years, nor for TNBC or non-TNBC among women 41-45 years of age. In conclusion, significant heterogeneity exists for the association of OC use and breast cancer risk between TNBC and non-TNBC among young women, lending support to a distinct etiology.