A PROSPECTIVE-STUDY OF THE DEVELOPMENT OF BREAST-CANCER IN 16,692 WOMEN WITH BENIGN BREAST DISEASE
A PROSPECTIVE-STUDY OF THE DEVELOPMENT OF BREAST-CANCER IN 16,692 WOMEN WITH BENIGN BREAST DISEASE
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DOI：
10.1093/oxfordjournals.aje.a114995
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发表时间：
1988-09-01
影响因子：
5
通讯作者：
TAYLOR, PR
中科院分区：
文献类型：
--
作者：
CARTER, CL;CORLE, DK;TAYLOR, PR
作者对参加美国乳腺癌检测示范项目的16692名活检诊断为乳腺良性疾病的妇女进行了乳腺良性疾病与后续乳腺癌之间的关系研究。妇女被分为五类乳腺良性疾病之一：非典型增生、无非典型增生、非增生性疾病、纤维腺瘤和其他乳腺良性疾病。从1973年8月至1986年2月，在诊断为乳腺良性疾病的中位随访期8.3年之后，共发现485例乳腺癌病例。计算按家族史和钙化状况分层的良性乳腺疾病类型的年龄调整发病率。五种良性乳腺疾病类别的女性患乳腺癌的相对风险（RR）估计，与未发生可识别的乳腺疾病的筛查女性（正常受试者）相比，使用比例风险模型计算。结果表明，风险与上皮异型性程度相关。在所有年龄组中，与正常受试者相比，患有非增生性疾病、无非典型增生的增生性疾病和非典型增生的女性的风险分别逐渐增加1.5、1.9和3.0,95%置信区间（CI）超过1。46岁以下的非典型增生女性的风险尤其高（RR = 5.7, 95% CI 3.0-10.6）。纤维腺瘤作为良性乳腺疾病的唯一指标的妇女的相对风险为1.7,95%置信限为1.0。患有其他良性乳腺疾病的女性没有增加患病风险。阳性家族史（RR = 1.8）和钙化（RR = 1.2）与各良性乳腺疾病亚型相关的风险成比例显著增加。作者得出结论，患乳腺癌的风险因乳腺良性疾病的种类而异，并与上皮非典型性的程度直接相关。
The authors studied the relation between benign breast diasese and subsequent breast cancer in 16,692 women with biopsy-diagnosed benign breast disease who had participated in the Breast Cancer Detection Demonstration Project throughout the United States. Women were classified into one of five benign breast disease categories: atypical hyperplasia, proliferative disease without atypia, nonproliferative disease, fibroadenoma, and other benign breast disease. A total of 485 incident cases of breast cancer were identified in the women from August 1973 to February 1986 after a median follow-up period of 8.3 years from the diagnosis of benign breast disease. Age-adjusted incidence rates were calculated for benign breast disease types stratified by family history and calcification status. Relative risk (RR) estimates of brest cancer for women in the five benign breast disease categories, compared with the screened women who did not develop recognizable breast disease (normal subjects), were computed using the proportional hazards model. Results indicated that risk was associated with the degree of epithelial atypia. Over all age groups, women with nonproliferative disease, proliferative disease without atypia, and atypical hyperplasia displayed progressively increasing risks of 1.5, 1.9, and 3.0, respectively, compared with normal subjects, with 95% confidence intervals (CI) exceeding unity. Particularly high risk was seen among women under age 46 years with atypical hyperplasia (RR = 5.7, 95% CI 3.0-10.6). Women with fibroadenoma as the only indication of their benign breast disease had a relative risk of 1.7, with a lower 95% confidence limit of 1.0. No increased risk was seen for women with other benign breast disease. Positive family history (RR = 1.8) and calcification (RR = 1.2) significantly increased a woman''s risk proportionately over the risk associated with each benign breast disease subtype. The authors conclude that the risk of developing breast cancer varies by category of benign brest disease and is directly related to the degree of epithelial atypia.