Relationship between menopausal symptoms and risk of postmenopausal breast cancer.
Relationship between menopausal symptoms and risk of postmenopausal breast cancer.
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DOI：
10.1158/1055-9965.epi-10-0998
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发表时间：
2011-02
期刊：
影响因子：
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通讯作者：
Li CI
中科院分区：
文献类型：
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作者：
Huang Y;Malone KE;Cushing-Haugen KL;Daling JR;Li CI
先前的研究表明，与没有更年期症状的女性相比，有更年期症状的女性在经历更年期时雌激素水平较低。鉴于激素在乳腺癌病因学中的核心作用，绝经期症状与乳腺癌之间的联系是合理的。然而，之前没有研究评估更年期症状和乳腺癌风险之间的关系。利用一项基于人群的病例对照研究的数据，我们研究了绝经后妇女更年期症状与不同组织学类型乳腺癌风险之间的关系。我们使用多元逻辑回归计算了多变量校正优势比（OR），并评估了几种潜在的影响调节因子。曾经有过更年期症状的妇女患浸润性导管癌的风险较低[IDC， OR=0.5；95%可信区间（CI）： 0.3-0.7]、浸润性小叶癌（ILC， OR=0.5; 95% CI: 0.3-0.8）和浸润性导管小叶癌（IDLC， OR=0.7; 95% CI: 0.4-1.2），这些风险的降低与激素治疗的近期和时间、绝经年龄和体重指数无关。在曾经经历过潮热的女性中，潮热强度的增加也与所有三种乳腺癌亚型的风险降低有关（趋势的p值均≤0.017）。这是第一项研究报告，经历过更年期症状的女性患乳腺癌的风险大大降低，潮热的严重程度也与风险成反比。如果得到证实，这些发现可以增强我们对乳腺癌病因和潜在相关预防因素的理解。
Prior studies indicate that women with menopausal symptoms have lower estrogen levels as they go through menopause compared to women who do not experience them. Given the central role of hormones in the etiology of breast cancer, a link between menopausal symptoms and breast cancer is plausible. However, no prior studies have evaluated the association between menopausal symptoms and breast cancer risk. Utilizing data from a population-based case-control study we examined associations between menopausal symptoms and risks of different histologic types of breast cancer among postmenopausal women. We calculated multivariate adjusted odds ratios (OR) using polytomous logistic regression and evaluated several potential effect modifiers. Women who ever experienced menopausal symptoms had lower risks of invasive ductal carcinoma [IDC, OR=0.5; 95% confidence interval (CI): 0.3–0.7], invasive lobular carcinoma (ILC, OR=0.5; 95% CI: 0.3–0.8), and invasive ductal-lobular carcinoma (IDLC, OR=0.7; 95% CI: 0.4–1.2), and these reductions in risk were independent of recency and timing of hormone therapy use, age at menopause, and body mass index. Increasing intensity of hot flashes among women who ever experienced hot flashes was also associated with decreasing risks of all three breast cancer subtypes (p-values for trend all ≤0.017). This is the first study to report that women who ever experienced menopausal symptoms have a substantially reduced risk of breast cancer, and that severity of hot flashes is also inversely associated with risk. If confirmed, these findings could enhance our understanding of breast cancer etiology and factors potentially relevant to prevention.