AGE AT ONSET AS AN INDICATOR OF FAMILIAL RISK OF BREAST-CANCER
AGE AT ONSET AS AN INDICATOR OF FAMILIAL RISK OF BREAST-CANCER
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DOI：
10.1093/oxfordjournals.aje.a115616
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发表时间：
1990-06-01
影响因子：
5
通讯作者：
THOMPSON, D
中科院分区：
文献类型：
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作者：
CLAUS, EB;RISCH, NJ;THOMPSON, D
乳腺癌的家族性风险是由疾病控制中心进行的一项大型人群病例对照研究调查的。该数据集包括4，730例年龄在20-54岁之间的组织学证实的乳腺癌病例和4，688例对照，这些对照与地理区域和5岁年龄类别的病例频率相匹配。利用病例组和对照组的一级女性亲属中的乳腺癌家族史。为了确定与乳腺癌家族风险相关的因素，采用考克斯比例风险模型，对母亲和姐妹篇之间乳腺癌发病时间进行建模。病例亲属比对照亲属的风险更大。在病例的亲属中，乳腺癌风险的显着增加与病例发病时年龄的降低以及有额外的亲属患有乳腺癌有关。50岁时诊断为乳腺癌的母亲的风险比为1.7（95%置信区间（CI）1.4-2.0），而40岁和30岁时诊断为乳腺癌的母亲的风险比分别为2.7（95% CI 2.2-3.2）和4.3（95% CI 3.3-5.6）。一个病例的姐妹有一个未受影响的母亲和至少一个受影响的姐妹，除了病例的风险比为3.6（95% CI 2.1-6.1）当病例在50岁时被诊断时，而在40岁和30岁确诊时分别为5.8（95%CI 3.4-10.0）和9.4（95%CI 5.3-16.7）。当病例在50岁时被诊断时，其姐妹（母亲受影响且无其他受影响姐妹篇）的风险比为5.9（95%CI 3.9-8.9），而当病例在40岁和30岁时被诊断时，风险比分别为9.4（95%CI 6.2-14.4）和15.1（95%CI 9.4-24.3）。一个病例的姐妹同时有一个受影响的母亲和至少一个受影响的姐妹，其风险比为17.1（95%CI 9.4-31.3）当病例在50岁时被诊断时，而在40岁和30岁确诊时分别为27.5（95%CI 15.0-50.3）和44.2（95%CI 23.5-83.2）。没有发现病例的绝经状态和双侧性的影响，表明除了阳性家族史外，发病年龄是这些数据中乳腺癌可能遗传亚型的最强指标。
The familial risk of breast cancer was investigated in a large population-based, case-control study conducted by the Centers for Disease Control. The data set included 4,730 histologically confirmed breast cancer cases aged 20-54 years and 4,688 controls who were frequency matched to cases by geographic region and 5-year categories of age. Family history of breast cancer among first-degree female relatives of cases and controls was utilized. To identify factors associated with familial risk of breast cancer, a Cox proportional hazards model was used, modeling time to onset of breast cancer among mothers and sisters. Case relatives were at greater risk than control relatives. Among relatives of cases, a significant increase in the risk of breast cancer was associated with decreasing age at onset of the case and with having an additional relative affected with breast cancer. The hazard ratio for the mother of a case with breast cancer diagnosed at 50 years of age was 1.7 (95% confidence interval (Cl) 1.4-2.0), compared with 2.7 (95% Cl 2.2-3.2) and 4.3 (95% Cl 3.3-5.6) for the mother of a case whose diagnosis occurred at 40 and 30 years of age, respectively. The hazard ratio for the sister of a case with an unaffected mother and at least one affected sister in addition to the case was 3.6 (95% Cl 2.1-6.1) when the case was diagnosed at age 50, compared with 5.8 (95% Cl 3.4-10.0) and 9.4 (95% Cl 5.3-16.7) when the case was diagnosed at 40 and 30 years of age, respectively. The hazard ratio for the sister of a case with an affected mother and no additional affected sisters was 5.9 (95% Cl 3.9-8.9) when the case was diagnosed at age 50, compared with 9.4 (95% Cl 6.2-14.4) and 15.1 (95% Cl 9.4-24.3) when the case was diagnosed at 40 and 30 years of age, respectively. The hazard ratio for the sister of a case with both an affected mother and at least one affected sister aside from the case was 17.1 (95% Cl 9.4-31.3) when the case was diagnosed at age 50, compared with 27.5 (95% Cl 15.0-50.3) and 44.2 (95% Cl 23.5-83.2) when the case was diagnosed at 40 and 30 years of age, respectively. No effect of case''s menopausal status and bilaterality was found, indicating that in addition to a positive family history, age at onset is the strongest indicator of a possible genetic subtype of breast cancer in these data.