Examining breast cancer growth and lifestyle risk factors: early life, childhood, and adolescence.
Examining breast cancer growth and lifestyle risk factors: early life, childhood, and adolescence.
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DOI：
10.3816/cbc.2008.n.038
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发表时间：
2008-08
影响因子：
3.1
通讯作者：
Hartman TJ
中科院分区：
文献类型：
--
作者：
Ruder EH;Dorgan JF;Kranz S;Kris-Etherton PM;Hartman TJ
围产期、儿童期和青春期是乳腺癌风险发展的重要时期。内源性雌激素暴露在子宫内被认为是最高的，一生中暴露于雌激素在增加乳腺癌风险中起着重要作用。一些证据表明，乳房组织直到第一次足月妊娠后才完全分化；因此，乳房组织在生命早期和青春期可能更容易受到致癌影响。女儿的出生特征，包括胎龄、出生体重和出生身长与指数妊娠期间母亲的激素水平有关，而出生尺寸与女儿的青春期时间和成年乳腺癌发病率有关。此外，生命早期和青春期是下丘脑-垂体-卵巢轴成熟的关键时期，下丘脑-垂体-卵巢轴调节卵巢激素的产生，包括雌激素和黄体酮。儿童时期的身高、成长、饮食和身体质量指数（BMI）也与以后患乳腺癌的风险有关。根据研究的特征，我们得出结论，现有证据表明乳腺癌风险与出生体重、出生长度和青春期身高呈正相关，与胎龄和儿童体重指数呈负相关，尽管文献中存在一些不一致的地方。青少年饮食与成年乳腺癌风险之间关系的最佳证据是间接的，儿童时期饮食、体重状况和体重增加之间的关系值得进一步关注。除了基因与环境的相互作用外，出生特征与生命过程中确定的风险因素（如初潮年龄）的相互作用还需要更多的研究。还需要进一步的研究来阐明影响观察到的关联的生物学机制。
The perinatal period, childhood, and adolescence are important intervals for breast cancer risk development. Endogenous estrogen exposure is thought to be highest in utero, and exposure to estrogens throughout life plays an important role in increasing breast cancer risk. Some evidence suggests that breast tissue is not fully differentiated until after the first full-term pregnancy; thus, breast tissue might be more susceptible to carcinogenic influences during early life and adolescence. Birth characteristics of the daughter, including gestational age, birth weight, and birth length are associated with maternal hormone levels during the index pregnancy, and birth size has been related to daughter's timing of puberty and adult breast cancer incidence. Furthermore, early life and adolescence are critical times for maturation of the hypothalamic pituitary ovarian axis, which regulates production of ovarian hormones including estrogen and progesterone. Childhood height, growth, diet, and body mass index (BMI) have also been associated with breast cancer risk later in life. Of the examined characteristics, we conclude that the available evidence is suggestive of a positive relationship of breast cancer risk with birth weight, birth length, and adolescent height, and an inverse relationship with gestational age and childhood BMI, although several inconsistencies exist in the literature. The best evidence for a relationship of adolescent diet and adult breast cancer risk is indirect, and the relationship of diet, weight status, and weight gain in childhood deserves further attention. The interaction of birth characteristics with established risk factors over the life course, such as age at menarche, in addition to gene-environment interactions, require more research. Further study is also needed to clarify the biologic mechanisms influencing the observed associations.