乳腺癌的危险因素与绝经状态的关系

RISK FACTORS FOR BREAST CANCER RELATES TO THE MENOPAUSAL STATUS AT DIAGNOSIS

有些作者认为乳腺癌的危险或保护因素在诊断年龄不同的乳腺癌患者之间有差异。已有的研究表明卵巢活动对乳腺癌的发生具有重要作用。诊断于绝经前(卵巢有活动)与绝经后(卵巢无活动)的乳腺癌的危险因素是否不同呢?本文的目的旨在通过对绝经前、绝经后诊断的乳腺癌患者及相应对照的某些特征进行分析,探索上海地区乳腺癌的危险因素与绝经状态的关系,为乳腺癌的发病机理和可行的预防措施提供线索。

Ovarian activity is the major determinant for breast cancer risk. The interview dataof 204 pre-menopausal pairs and 271 post-menopausal pairs from the population-basedcase-control study of breast cancer in Shanghai by individually matched on age andmenopausal status were analysea to investigate the different risk factors for breast cancerdiagnosed in pre--(having ovarian activity) and post-menopausal (having no ovarianactivity)women.The estimate for relative risks (OR) and their 95%confidence intervals(95% CI) were calculated by using standard matched pair methods. The conditionalLogistic regression method was used for meltivariate analysis. The results showed thatshort length of menstrual cycle(<25vs30+days:OR=3.4;95% CI: 1. 4--8. 1) andhistory of benign breast diseses (OR=5.4 195% CI: 2. 1--14.7) were risk factors forpre-menopausal women and that heavy weight and high intake of fat were risk factorsfor postmenopausal women, Although early age at first full-term pregnancy, highparity and long duration of lactation were all protective factors for both pre--and post-menopausal women, the results revealed by meltivariate analysis were that prolongedlactation had strongest protective effect for premenopausal women, among premenopau-sal women who had lactated for at least 3 years had only 50% of OR compared to womenwho had never lactated, and that high parity had most remarkable protective effect forpost-menspauoal women. The higher intake of vitamine C, as a marker of intake ofvegetables and fruits,tho lower tho relative risk. The results of this study are of impor-tance for protection of breast cancer. Prolonged lactation, high intake of vegetables andfruits, and weight control and low intake of fat in post-menopausal women willdecrease the risk for breast cancer.