Early life factors and incidence of proliferative benign breast disease
Early life factors and incidence of proliferative benign breast disease
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DOI：
10.1158/1055-9965.epi-05-0525
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发表时间：
2005-12-01
影响因子：
3.8
通讯作者：
Colditz, GA
中科院分区：
文献类型：
--
作者：
Baer, HJ;Schnitt, SJ;Colditz, GA
乳腺增生性良性疾病是乳腺癌风险增加的一个标志，但对其病因知之甚少。尽管越来越多的证据表明，早期生活中的因素会影响乳腺癌的风险，但大多数关于良性乳腺疾病的研究只关注成年期的风险因素。我们在护士健康研究II中探讨了71896名绝经前妇女的早期生活因素与增生性良性乳腺疾病发病率的关系，这些妇女回忆了她们年轻时的身体肥胖、青春期的身体活动、出生体重和母乳喂养史。在1991年至1997年期间，901名妇女在集中病理检查中被确定为患有增生性良性乳腺疾病。根据Cox比例风险模型估计相对风险（RR）和95%置信区间（95% CI）。儿童期身体肥胖（5-10岁）与增殖性良性乳腺疾病风险降低相关；最超重与最瘦的多变量RR （95% CI）为0.61 (0.44-0.86；p趋势< 0.0001)，在调整当前体重指数后仍然显著。18岁时的体重指数也与增生性良性乳腺疾病的发病率呈负相关，>= 25 kg/m(2)与< 19 kg/m(2)的多变量RR （95% CI）为0.67 (0.52-0.88)（p趋势= 0.001）。青少年时期的体力活动、出生体重或母乳喂养没有明确的联系。这些结果表明，年轻时体重较重的绝经前妇女患乳腺增生性良性疾病的几率较低，这与先前对乳腺癌的研究结果一致。
Proliferative benign breast disease is a marker of increased breast cancer risk, yet little is known about its etiology. Most studies of benign breast disease have focused only on risk factors in adulthood, despite growing evidence that factors in early life influence breast cancer risk. We explored the relations of several early life factors with incidence of proliferative benign breast disease among 71,896 premenopausal women in the Nurses' Health Study II who recalled their body fatness at young ages, physical activity in adolescence, birthweight, and history of being breastfed. Between 1991 and 1997, 901 of these women were identified as having proliferative benign breast disease from a centralized pathology review. Relative risks (RR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazards models. Greater childhood body fatness (ages 5-10) was associated with decreased risk of proliferative benign breast disease; the multivariate RR (95% CI) for the most overweight compared with the most lean was 0.61 (0.44-0.86; P-trend < 0.0001) and remained significant after adjustment for current body mass index. Body mass index at age 18 was also inversely associated with incidence of proliferative benign breast disease, with a multivariate RR (95% CI) of 0.67 (0.52-0.88) for those who were >= 25 kg/m(2) compared with those who were < 19 kg/m(2) (P-trend = 0.001). There were no clear associations for physical activity in adolescence, birthweight, or being breastfed. These results indicate that premenopausal women who were heavier at young ages have lower incidence of proliferative benign breast disease, consistent with previous findings for breast cancer.