Family History, Reproductive, and Lifestyle Risk Factors for Fibroadenoma and Breast Cancer
Family History, Reproductive, and Lifestyle Risk Factors for Fibroadenoma and Breast Cancer
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DOI：
10.1093/jncics/pky051
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发表时间：
2018-07-01
影响因子：
4.4
通讯作者：
Czene, Kamila
中科院分区：
文献类型：
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作者：
Li, Jingmei;Humphreys, Keith;Czene, Kamila
背景：为了了解哪些乳腺癌(BC)危险因素也会增加纤维腺瘤的风险，并调查这些因素在有纤维腺瘤病史的BC患者中是否具有相同的影响。方法：在一个大型数据集(n=58322)上进行多状态生存分析，我们检查了BC危险因素对三种状态之间转换的影响：无事件、活检证实的纤维腺瘤和BC。估计了与协变量效应相关的危险比和相应的95%可信区间。中位随访时间为25.3年。结果：纤维腺瘤和BC的平均诊断年龄分别为42.6岁和48.3岁。已知会增加BC风险的参与者特征被发现会增加纤维腺瘤的风险(BC家族史和高等教育)。已知的参与者特征对BC具有保护作用(月经初潮年龄较大、孩子较多、童年时体型较大)可降低纤维腺瘤的风险。在被测试的协变量中，与从无事件到纤维腺瘤和BC的直接转变相关的效应大小通常没有不同。纤维腺瘤的诊断年龄与从纤维腺瘤向BC的转变有关(风险比(每年增加)=1.07(95%可信区间=1.03~1.12))。结论：我们发现经活检证实的纤维腺瘤与BC有许多共同的危险因素。需要更多的工作来了解纤维腺瘤和BC之间的关系，以确定在纤维腺瘤诊断后发生BC的高危女性。
Background: To understand which breast cancer (BC) risk factors also increase the risk of fibroadenoma and investigate whether these factors have the same effect in BC patients with previous fibroadenoma.Methods: Using multistate survival analysis on a large dataset (n = 58 322), we examined the effects of BC risk factors on transitions between three states: event-free, biopsy-confirmed fibroadenoma, and BC. Hazard ratios and corresponding 95% confidence intervals associated with covariate effects were estimated. Median follow-up time was 25.3 years.Results: The mean ages at diagnosis of fibroadenoma and BC were 42.6 and 48.3 years, respectively. Participant characteristics known to increase the risk of BC were found to increase the risk of fibroadenoma (family history of BC and higher education). Participant characteristics known to confer protective effects for BC (older age at menarche, more children, and larger childhood body size) were found to reduce fibroadenoma risk. The effect sizes associated with the direct transitions from eventfree to fibroadenoma and BC were generally not different for the covariates tested. Age at fibroadenoma diagnosis was associated with the transition from fibroadenoma to BC (hazard ratio(per year increase) =1.07 (95% confidence interval = 1.03 to 1.12]).Conclusion: We showed that biopsy-confirmed fibroadenomas shared many risk factors with BC. More work is needed to understand the relationships between fibroadenoma and BC to identify women who are at high risk of developing BC after a fibroadenoma diagnosis.