Medical radiation, family history of cancer, and benign breast disease in relation to breast cancer risk in young women, USA
Medical radiation, family history of cancer, and benign breast disease in relation to breast cancer risk in young women, USA
复制标题
DOI：
10.1023/a:1020201106117
复制
发表时间：
2002-10-01
影响因子：
2.3
通讯作者：
Bernstein, L
中科院分区：
文献类型：
--
作者：
Hill, DA;Preston-Martin, S;Bernstein, L
目的：在以前的研究中，接受高剂量（超过100-200 cGy）电离辐射或在20岁之前接受低剂量电离辐射的妇女患乳腺癌的风险增加。一些证据表明，在有乳腺癌或卵巢癌家族史的女性（可能只有特定基因突变的携带者）和患有良性乳腺疾病（BBD）的女性中，这种风险可能明显升高。方法：洛杉矶县的一项基于人群的病例对照研究获得了1983-1988年期间744名年龄在40岁或40岁以下诊断为乳腺癌的女性和744名匹配对照的访谈数据。有乳腺癌或卵巢癌阳性家族史的妇女报告其母亲、姐妹或祖母患有癌症。患有BBD的女性报告有医生诊断。辐射暴露被定义为放射治疗史或中度医学放射照相史。结果：20岁前接受医疗辐射的女性患乳腺癌的风险高于未接受医疗辐射的女性(优势比（OR) = 1.4, 95%可信区间(CI) = 1.2-1.8）。仅在有BBD病史的女性中观察到这种风险增加（OR = 2.4, 95% CI = 1.6-3.7）。总体而言，风险与20岁以后的医疗辐射暴露无关，尽管在乳腺癌或卵巢癌家族史阳性的妇女中，暴露的妇女风险增加（or = 1.8, 95% CI = 1.0-3.1）。有乳腺癌/卵巢癌家族史的妇女在20岁前接受医疗辐射，或患有BBD的妇女在20岁后接受医疗辐射，其患乳腺癌的风险没有增加。讨论：研究参与者可能已经接受了不再常见的辐射剂量，阻碍了研究的普遍性。虽然不能完全排除病例和对照组之间的回忆差异，但在本研究中，患有BBD或有乳腺癌家族史的女性在相对较低的电离辐射暴露后，患乳腺癌的风险似乎比其他女性更高。
Objective: In previous studies breast cancer risk has been increased among women who received high doses (above 100-200 cGy) of ionizing radiation or those exposed to lower doses prior to age 20. Some evidence suggests that such risk may be distinctly elevated among women with a family history of breast or ovarian cancer (probably only carriers of specific gene mutations) and women with benign breast disease (BBD).Methods: A population-based case-control study in Los Angeles County obtained interview data from 744 women who were aged 40 or younger and diagnosed with breast cancer during 1983-1988, and from 744 matched controls. Women with a positive family history of breast or ovarian cancer reported cancer in a mother, sister, or grandmother. Women with BBD reported a physician diagnosis. Radiation exposure was defined as a history of either radiation therapy or moderate exposure to medical radiography.Results: Breast cancer risk was elevated among women exposed to medical radiation prior to age 20 years (odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.2-1.8), relative to unexposed women. This increased risk was observed only among women with a history of BBD (OR = 2.4, 95% CI = 1.6-3.7). Overall, risk was not associated with exposure to medical radiation after age 20 years, although among women with a positive family history of breast or ovarian cancer, exposed women had an increased risk (OR = 1.8, 95% CI = 1.0-3.1). Breast cancer risk was not increased among women with a family history of breast/ovarian cancer exposed to medical radiation before age 20 years or those with BBD exposed to medical radiation after age 20 years.Discussion: Study participants may have received radiation doses that are no longer common, hampering study generalizability. Although differences in recall between cases and controls cannot be completely excluded, women with BBD or a family history of breast cancer appear to have greater breast cancer risk following relatively low ionizing radiation exposure than other women in this study.