A PROSPECTIVE-STUDY OF BENIGN BREAST DISEASE AND THE RISK OF BREAST-CANCER
A PROSPECTIVE-STUDY OF BENIGN BREAST DISEASE AND THE RISK OF BREAST-CANCER
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DOI：
10.1001/jama.267.7.941
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发表时间：
1992-02-19
影响因子：
120.7
通讯作者：
COLDITZ, GA
中科院分区：
文献类型：
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作者：
LONDON, SJ;CONNOLLY, JL;COLDITZ, GA
Objective. - 研究良性增生性乳腺疾病伴或不伴不典型增生与乳腺癌发生风险之间的关系。- 嵌套在前瞻性队列研究中的病例对照研究。乳腺活检后的中位随访时间为8年（第25至第75百分位数，5至14年）。- 从1976年至1986年随访的121700名美国注册护士的前瞻性队列中选择。病例为乳腺癌女性，既往曾因良性乳腺疾病接受过活检。对照组是随机选择的，并在活检年份和出生年份从队列中有良性乳腺活检但未患乳腺癌的妇女中进行匹配。分析中包括121例病例和488例对照。- 乳腺癌的发展。- 第一次良性乳腺活检的切片由两名对结果不知情的乳腺病理学家进行审查。相对于无增殖性疾病的女性，乳腺癌的多重校正相对风险（RR）为1.6，增殖性疾病无乳腺癌（95%置信区间[CI]，1.0至2.5），非典型增生为3.7（95% CI，2.1至6.8）。与绝经后妇女（RR = 2.3; 95%CI，0.9 - 5.9）相比，绝经前妇女乳腺癌风险与非典型增生的相关性更强（RR = 5.9; 95%CI，2.9 - 13.2），但乳腺癌风险与无乳腺增生的增生性疾病的相关性在绝经状态之间没有差异。- 这些结果证实了乳腺癌的风险显着增加妇女不典型增生，特别是在绝经前妇女，并建议这些妇女应鼓励进行频繁的乳腺癌筛查。
Objective. - To examine the relation between proliferative benign breast disease with and without atypical hyperplasia and the subsequent risk of breast cancer.Design. - Case-control study nested within a prospective cohort study. Median follow-up after breast biopsy was 8 years (25th to 75th percentile, 5 to 14 years).Participants. - Selected from a prospective cohort of 121 700 US registered nurses followed up from 1976 to 1986. Cases were women with breast cancer who had a prior biopsy for benign breast disease. Controls were randomly selected and matched on year of biopsy and year of birth from among women in the cohort who had a benign breast biopsy but who did not develop breast cancer. Included in the analysis were 121 cases and 488 controls.Main Outcome Measure. - Development of breast cancer.Results. - Slides from the first benign breast biopsy were reviewed by two breast pathologists blinded to the outcome, The multiply adjusted relative risks (RRs) for breast cancer, relative to women with no proliferative disease, were 1.6 for proliferative disease without atypia (95% confidence interval [Cl], 1.0 to 2.5) and 3.7 for atypical hyperplasia (95% Cl, 2.1 to 6.8). Breast cancer risk was more strongly associated with atypical hyperplasia among premenopausal women (RR = 5.9; 95% Cl, 2.9 to 13.2) than postmenopausal women (RR = 2.3; 95% CI, 0.9 to 5.9), but the association of breast cancer risk with proliferative disease without atypia did not differ across menopausal status.Conclusion. - These results confirm the marked increase in breast cancer risk among women with atypical hyperplasia, particularly in premenopausal women, and suggest that these women should be encouraged to undergo frequent breast cancer screening.