Benign breast disease

良性乳腺疾病
  • 文章类型: Journal Article
    背景:乳腺癌和乙型肝炎病毒(HBV)之间的相关性仍然没有定论。本研究旨在探讨不同年龄组女性乳腺癌患者HBV感染及既往感染的血清学状况,良性乳腺疾病患者,和接受常规体检的个人。
    方法:收集并分析了2012年9月至2020年7月在重庆医科大学附属第一医院首次诊断的6072例女性乳腺癌患者的HBV血清学标志物的血清数据。以及同期接受常规体检的4019名良性乳腺疾病女性和54740名健康女性。数据按年龄分层,以进行组间比较。
    结果:乳腺癌组中HBV感染和过去感染的患病率(7.9%,55.1%)高于良性乳腺疾病组(6.5%,39.1%)和健康女性组(5.0%,17.6%);乳腺癌组仅HBV表面抗体阳性率(HBsAb(+))(10.3%)低于良性乳腺疾病组(26.9%)和健康女性组(49.2%),三组间差异有统计学意义(p<0.05)。按年龄分层,乳腺癌组中HBV感染的患病率(8%,8.9%)和良性乳腺疾病组(7.75%,8.1%)高于健康女性组(4.5%,6.3%)在30-39岁和40-49岁年龄段,分别。乳腺癌组HBV过去感染率(24.8%,45.0%)高于良性乳腺疾病组(16.1%,35.4%)在≤29岁和30-39岁年龄组,分别。.在所有年龄组中,乳腺癌组的HBV过去感染率均高于健康女性组,而乳腺癌组仅HBsAb(+)的比率低于良性乳腺疾病组及各年龄组常规体检组。
    结论:乳腺癌妇女和良性乳腺疾病妇女的乙肝病毒感染率和既往感染率较高,中年妇女之间的差异更大。乳腺癌妇女和良性乳腺疾病的妇女只有HBsAb(+)对HBV的发生率较低。
    BACKGROUND: The correlation between breast cancer and hepatitis B virus (HBV) remains inconclusive. This study aims to explore the serological status of HBV infection and past infection in different age groups of female breast cancer patients, patients with benign breast diseases, and individuals undergoing routine physical examinations.
    METHODS: Serum data on HBV serological markers were collected and analyzed from 6072 female breast cancer patients first diagnosed from September 2012 to July 2020 at the First Affiliated Hospital of Chongqing Medical University, along with 4019 women with benign breast diseases and 54,740 healthy females undergoing routine physical examinations in the same period. The data were stratified by age for comparison between groups.
    RESULTS: The prevalence of HBV infection and past infection in the breast cancer group (7.9%, 55.1%) was higher than that in the benign breast disease group (6.5%, 39.1%) and the healthy females group(5.0%, 17.6%);the rate of only HBV surface antibody positivity (HBsAb ( +)) in the breast cancer group (10.3%) was lower than that in the benign breast disease group (26.9%) and the healthy females group (49.2%), with significant differences between the three groups (p < 0.05). Stratified by age, the prevalence of HBV infection in the breast cancer group (8%, 8.9%) and benign breast disease group (7.75%, 8.1%)was higher than that in the healthy females group (4.5%, 6.3%) in the 30-39 and 40-49 age group, respectively. The past infection rate of HBV in the breast cancer group (24.8%, 45.0%) was higher than that in the benign breast disease group (16.1%, 35.4%) in the ≤ 29 and 30-39 age group, respectively.. The past infection rate of HBV in the breast cancer group was higher than that in the healthy females group in all age groups, while the rate of only HBsAb ( +) in the breast cancer group was lower than that in the benign breast disease group and the routine physical examination group in all age groups.
    CONCLUSIONS: Breast cancer women and women with benign breast diseases have higher rates of hepatitis B virus infection and previous infections, with more significant differences among middle-aged women. Breast cancer women and women with benign breast diseases have lower rates of only HBsAb ( +) for HBV.
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  • 文章类型: Case Reports
    背景:假性血管瘤性基质增生(PASH)是一种罕见的乳腺基质病变,通常在临床上表现为可触及的单侧,无痛肿块,可自由移动,并具有橡胶或牢固的一致性。诊断可以通过芯针活检(CNB)或手术切除来确认。治疗选择包括对无症状患者进行激素治疗或在极少数情况下进行局部切除和乳房缩小。
    方法:我们报道了一例24岁女性,有服用避孕药约一年的历史。检查显示极其扩大,疼痛,乳房肿胀,尤其是右侧,标志着她的第三次PASH复发。该患者使用一种新颖的技术进行了外科皮肤减少乳房切除术(SRM),该技术采用了直接由真皮皮瓣覆盖的胸前植入物,以重建由于较大的PASH病变的乳房形状,并旨在获得最佳的美容效果。随访18个月,手术无并发症,无复发。
    结论:乳房切除术后立即植入具有以下益处:迅速恢复乳房形状,减少手术。
    结论:本病例报告强调了立即植入在重建大型复发性良性乳腺疾病中的成功应用。结果表明,对于精心选择的大型患者,立即植入有望成为合适的选择,复发性双侧良性乳腺疾病。然而,由于常见的并发症,如感染和植入物丢失,一般不推荐用于良性病变。应根据具体情况作出决定,考虑到大小,复发,和个人适用性。
    BACKGROUND: Pseudoangiomatous stromal hyperplasia (PASH) is a rare breast stromal lesion that typically manifests clinically as a palpable unilateral, painless lump that is freely movable and has a rubbery or firm consistency. The diagnosis can be confirmed by a core needle biopsy (CNB) or surgical excision. Treatment options include medical treatment with hormonal management for asymptomatic patients or local excision and breast reduction in rare cases.
    METHODS: We reported the case of a 24-year-old woman with a history of taking contraceptive pills for about a year. Examination revealed extremely enlarged, sore, and swollen breasts, particularly the right side, marking her third PASH relapse. The patient underwent a surgical skin-reducing mastectomy (SRM) using a novel technique with an immediate prepectoral implant covered by a dermal flap to reconstruct the breast shape due to the large PASH lesions and aiming for optimal cosmetic outcomes. The procedure was complication-free with no recurrence after 18 months of follow-up.
    CONCLUSIONS: Mastectomy followed by immediate implantation offers benefits such as prompt restoration of breast shape with fewer surgeries.
    CONCLUSIONS: This case report highlights the successful use of immediate implantation in reconstructing large recurrent benign breast diseases. The outcomes indicate that immediate implantation shows promise as a suitable choice for carefully selected patients managing large, relapsing bilateral benign breast diseases. However, due to common complications such as infection and implant loss, it is not generally recommended for benign lesions. The decision should be made on a case-by-case basis, considering the size, recurrence, and individual suitability.
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  • 文章类型: Journal Article
    在乳腺诊所寻求医疗护理的女性通常患有非恶性乳腺疾病,包括非特异性乳房疼痛或纤维腺瘤等明显肿块。由于其可变性,可能很难量化乳房疼痛。这项研究的目的是比较centchroman和月见草油,以确定一种具有成本效益的,安全,和有效治疗良性乳腺疾病。
    在这项以医院为基础的前瞻性观察研究中,纳入100例伴或不伴肿块1年的乳腺疾病,分为两组,每组50例,A组(Centchroman)和B组(月见草油)。
    与月见草油相比,Centchroman表现出明显更大的缓解无痛乳痛的治疗反应。此外,centchroman表现出优异的反应(P<.05)。在患有乳腺痛的参与者中,与月见草油相比,centchroman显着减少了治疗后结节状疼痛患者的数量(P=.035)。在纤维腺瘤的基础上,在centchroman组中,部分和完全反应在较高数量的病例中显着(P=.007)。
    Centchroman治疗表明良性乳腺疾病的治疗是安全的,有效,和经济。
    UNASSIGNED: Females seeking medical attention at breast clinics commonly present with nonmalignant breast conditions, including nonspecific breast pain or distinct masses like fibroadenomas. Due to its variability, it may be difficult to quantify breast pain. The purpose of the research was to compare centchroman and evening primrose oil to identify a cost-effective, secure, and efficient treatment for benign breast disease.
    UNASSIGNED: In this prospective hospital-based observational study, 100 breast diseases with or without lumpiness for 1 year were included and divided into two groups with 50 cases each, Group-A (Centchroman) and Group-B (Evening primrose oil).
    UNASSIGNED: Centchroman exhibited a significantly greater treatment response for alleviating pain-free mastalgia compared to evening primrose oil. Additionally, centchroman showed an excellent response (P < .05). Among participants with mastalgia, centchroman significantly reduced the number of mastalgia patients with tender nodularity post-treatment (P = .035) than evening primrose oil. On the basis of fibroadenoma, partial and complete response was significantly seen in higher number of cases in the centchroman group (P = .007).
    UNASSIGNED: Centchroman therapy demonstrates that the treatment for benign breast disease is safe, effective, and economical.
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  • 文章类型: Journal Article
    大多数导管原位癌(DCIS)病变早期表现为钙化,可能是良性或恶性的.DCIS和良性乳腺疾病中可疑钙化的分类组对于早期评估患者的危险因素和计划治疗方案具有重要的临床意义。
    比较DCIS和良性乳腺疾病可疑钙化的影像学特征。
    2011年6月至2020年10月在Thammasat大学医院进行了101个可疑钙化的回顾性研究。通过乳房X线照相术引导的金属丝定位手术切除钙化。根据美国放射学会第五版乳腺成像报告和数据系统词典,对可疑钙化的乳房X线特征进行了审查。为了比较两组之间的差异,学生t检验,采用Fisher精确检验和Mann-WhitneyU检验进行统计分析。对DCIS预测进行logistic回归分析。
    101例可疑钙化灶的病理结果均为DCIS(30例)和良性乳腺疾病(71例)。线性形态和节段分布与DCIS显著相关(分别为p=0.003和p=0.024)。经过多变量分析,细线性钙化仍然显著升高DCIS的风险(奇数比率,51.72[95%置信区间:2.61,1022.89],p值为0.01),然而,预测DCIS的几率在任何分布之间均无统计学差异.
    与良性乳腺疾病相比,导管原位癌钙化具有对比的形态和分布特征。钙化描述符被认为是早期诊断的重要工具,可将DCIS与其他良性乳腺疾病区分开来。
    钙化描述符被认为是早期诊断和区分DCIS与其他良性乳腺疾病的重要手段。
    UNASSIGNED: Most ductal carcinoma in situ (DCIS) lesions manifest early as calcifications, which could be benign or malignant. The classified group of suspicious calcifications among DCIS and benign breast disease is clinically important to early evaluate patient risk factors and plan treatment options.
    UNASSIGNED: To compare imaging features of suspicious calcifications between DCIS and benign breast disease.
    UNASSIGNED: A retrospective study of 101 suspicious calcifications was performed at Thammasat University Hospital from June 2011 to October 2020. The calcifications were surgically excised by mammography-guided wire localisation. The mammographic features of the suspicious calcifications were reviewed according to the fifth edition of the American College of Radiology Breast Imaging-Reporting and Data System lexicon. For comparing between two groups, the student t-test, Fisher\'s exact test and Mann-Whitney U test were used for statistical analyses. The logistic regression analysis was calculated for DCIS prediction.
    UNASSIGNED: The pathologic results of all 101 suspicious calcifications were DCIS (30 cases) and benign breast disease (71 cases). Linear morphology and segmental distribution correlated significantly with DCIS (p = 0.003 and p = 0.024, respectively). After multivariable analysis, fine linear calcification still significantly elevated the risk of DCIS (odd ratios, 51.72 [95% confidence interval: 2.61, 1022.89], p-value of 0.01), however, the odds of predicting DCIS was not statistically significant different among any distribution.
    UNASSIGNED: Ductal carcinoma in situ calcification has contrasting morphology and distribution features compared to benign breast disease. The calcification descriptor is considered an important implement for early diagnosis and distinguishes DCIS from other benign breast conditions.
    UNASSIGNED: Calcification descriptor is considered an important implement for early diagnosis and distinguishment of DCIS from other benign breast conditions.
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  • 文章类型: Journal Article
    背景:手术是良性乳腺疾病的主要治疗方法,会对乳腺的正常生理造成一些破坏,即使这种中断是局部的,目前尚不清楚它是否会影响女性的母乳喂养能力。只有少数研究描述了接受良性乳腺疾病(BBD)手术的女性的母乳喂养经验。
    方法:我们回顾性分析了广东省20-40岁患者的数据,中国,患者于2013年1月1日至2019年6月30日期间在我科接受了BBD乳腺肿块切除术,随访日期为2022年2月1日.包括在手术时间和随访日期之间有分娩史的患者。通过收集有关这组患者的一般信息和有关手术后母乳喂养的信息,我们描述了先前接受过良性乳腺疾病手术的育龄妇女的母乳喂养结局.
    结果:中位随访时间为5.9年,共有333例患者符合纳入标准.从术后出生的第一个孩子的母乳喂养数据,“纯母乳喂养”的平均持续时间为5.1个月,任何母乳喂养的平均持续时间为8.8个月。“不断母乳喂养”的比例为91.0%,低于全国平均水平的93.7%,而六个月的纯母乳喂养率为40.8%,高于全国平均水平29.2%。12个月的母乳喂养率为30.0%,远低于全国平均水平66.5%。早期停止母乳喂养的常见原因是母乳不足。手术后曾进行过母乳喂养的患者中,有29.0%自愿减少了因手术而对手术乳房进行母乳喂养的频率和持续时间。
    结论:BBD手术对母乳喂养有一些影响,有些可能是心理上的。机构应为接受乳房手术的母亲提供更多的设施,以帮助她们进行母乳喂养,例如在乳房手术后进行母乳喂养的社区教育,在医院培训专业的术后哺乳顾问,延长产假。家庭应鼓励母亲用双乳母乳喂养,而不仅仅是非手术的乳房。
    BACKGROUND: Surgery is the primary treatment for benign breast disease and causes some disruption to the normal physiology of the breast, even when this disruption is localised, it remains unclear whether it affects women\'s ability to breastfeed. There are only a few studies describing the experience of breastfeeding in women who have undergone benign breast disease (BBD) surgery.
    METHODS: We retrospectively analysed data from patients aged 20-40 years in Guangdong, China, who underwent breast lumpectomy for BBD in our department between 01 January 2013 and 30 June 2019, with a follow-up date of 01 February 2022. Patients were included who had a history of childbirth between the time of surgery and the follow-up date. By collecting general information about this group of patients and information about breastfeeding after surgery, we described the breastfeeding outcomes of women of a fertile age who had previously undergone surgery for benign breast disease.
    RESULTS: With a median follow-up of 5.9 years, a total of 333 patients met the inclusion criteria. From the breastfeeding data of the first child born postoperatively, the mean duration of \'exclusive breastfeeding\' was 5.1 months, and the mean duration of \'any breastfeeding\' was 8.8 months. The rate of \'ever breastfeeding\' is 91.0%, which is lower than the national average of 93.7%, while the exclusive breastfeeding rate at six months was 40.8%, was higher than the 29.2% national average. The any breastfeeding rate at 12 months was 30.0%, which was well below the 66.5% national average. The common reason for early breastfeeding cessation was insufficient breast milk. A total of 29.0% of patients who had ever breastfed after surgery voluntarily reduced the frequency and duration of breastfeeding on the operated breast because of the surgery.
    CONCLUSIONS: There are some impacts of BBD surgery on breastfeeding and some may be psychological. Institutions should provide more facilities for mothers who have undergone breast surgery to help them breastfeed, such as conducting community education on breastfeeding after breast surgery, training professional postoperative lactation consultants in hospitals, and extending maternity leave. Families should encourage mothers to breastfeed with both breasts instead of only the non-operated breast.
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  • 文章类型: Journal Article
    诊断为良性乳腺疾病(BBD)的女性患乳腺癌的风险更高,但这些研究主要在非西班牙裔白人人群中进行。尽管如此,这些估计值已被用于为所有种族和族裔群体临床使用的乳腺癌风险模型提供信息.鉴于非洲裔美国人(AA)女性的高乳腺癌死亡率,在这个人群中研究BBD至关重要,以确保包含此信息的风险模型充分执行。这项研究利用了在底特律大学病理学小组服务的一家医院接受良性乳腺活检的AA女性的数据,密歇根州,从1998年到2010年。通过基于人群的底特律大都会癌症监测系统(MDCSS)对患者进行后续乳腺癌随访。BBD病变评分被指定为代表良性乳腺病变的严重程度或范围。较高的分数表明更多的不同的病变类型。在队列中,有3,461名合格的AA女性患有BBD,6.88%(n=238)随后发展为乳腺癌。单独检查,十一个病变中的六个(大汗腺化生,导管增生,小叶增生,导管内乳头状瘤,硬化性腺病,柱状改变和放射状疤痕)在调整年龄和活检年份后与乳腺癌风险增加显着相关,并在多病变模型中进一步考虑。对于每种不同类型的良性乳腺病变,在校正活检年龄和增殖性与非增殖性疾病后,后续乳腺癌风险增加25%(RR=1.25,95%CI:1.10,1.42).总之,这项研究证实了患BBD的AA女性患乳腺癌的风险增加,尤其是那些有多个病变的患者。这些发现对数百万受BBD影响的女性乳腺癌风险的管理具有重要意义。可从个性化监测和风险降低策略中获益的高危人群.
    The risk of developing subsequent breast cancer is higher in women diagnosed with benign breast disease (BBD) but these studies were primarily performed in non-Hispanic white populations. Still, these estimates have been used to inform breast cancer risk models that are being used clinically across all racial and ethnic groups. Given the high breast cancer mortality rates among African American (AA) women, it is critical to study BBD in this population, to ensure the risk models that include this information perform adequately. This study utilized data from AA women who underwent benign breast biopsies at a hospital served by the University Pathology Group in Detroit, Michigan, from 1998 to 2010. Patients were followed for subsequent breast cancers through the population-based Metropolitan Detroit Cancer Surveillance System (MDCSS). BBD lesion scores were assigned to represent the severity or extent of benign breast lesions, with higher scores indicating a greater number of distinct lesion types. Of 3,461 eligible AA women with BBD in the cohort, 6.88% (n=238) subsequently developed breast cancer. Examined individually, six of the eleven lesions (apocrine metaplasia, ductal hyperplasia, lobular hyperplasia, intraductal papilloma, sclerosing adenosis, columnar alterations and radial scars) were significantly associated with increased risk of breast cancer after adjustment for age and year of biopsy and were further considered in multiple lesion models. For every different type of benign breast lesion, subsequent risk of breast cancer increased by 25% (RR=1.25, 95% CI: 1.10, 1.42) after adjustment for age at biopsy and proliferative versus non-proliferative disease. In summary, this study affirms the increased breast cancer risk in AA women with BBD, particularly in those with multiple lesions. These findings have implications for the management of breast cancer risk in millions of women affected by BBD, a high risk group that could benefit from personalized surveillance and risk reduction strategies.
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  • 文章类型: Journal Article
    纤维囊性改变常见于有临床症状的患者和筛查发现的影像学检查期间。术语“纤维囊性改变”包括广泛的特定良性病理实体。对纤维囊性改变的经典良性发现的认识,包括囊肿和分层钙化,可以防止不必要的随访和活检。影像学发现,如实性肿块,非分层钙化,和建筑扭曲可能需要芯针活检诊断。在这些情况下,了解纤维囊性改变的各种表现有助于确定放射学-病理学的一致性。纤维囊性改变的治疗通常是保守的。
    Fibrocystic changes are commonly seen in clinically symptomatic patients and during imaging workup of screening-detected findings. The term \"fibrocystic changes\" encompasses a broad spectrum of specific benign pathologic entities. Recognition of classically benign findings of fibrocystic changes, including cysts and layering calcifications, can prevent unnecessary follow-ups and biopsies. Imaging findings such as solid masses, nonlayering calcifications, and architectural distortion may require core needle biopsy for diagnosis. In these cases, understanding the varied appearances of fibrocystic change aids determination of radiologic-pathologic concordance. Management of fibrocystic change is typically conservative.
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  • 文章类型: Journal Article
    良性乳腺疾病包括乳房内的一系列病变。虽然有些病变不会增加风险,其他人可能会将患乳腺癌的可能性提高4到5倍。这需要一种个性化的方法来筛查和优化女性的生活方式。更年期过渡是良性乳腺病变发展的关键时期。检测的增加可以归因于筛查乳房X线照相术的准确性和利用率的提高,使用或不使用补充成像。虽然人们普遍认为雌激素和孕激素联合治疗可能会增加患乳腺癌的风险,妇女健康倡议(WHI)的数据表明,单独使用雌激素治疗实际上可以降低癌症的总体风险.尽管有这种普遍的理解,关于激素治疗对患有特定良性乳腺病变的女性的风险状况的影响的信息存在显著差距.这篇综述全面检查了各种良性乳腺病变,深入研究他们的病理生理学和管理。目的是增强我们对何时以及如何明智地开出激素疗法的理解,特别是在特定的良性乳房疾病的情况下。通过弥合这一知识差距,这篇综述为优化良性乳腺疾病女性的医疗保健策略提供了有价值的见解,并为有关激素治疗的更明智的决策提供了基础。
    Benign breast disease encompasses a spectrum of lesions within the breast. While some lesions pose no increase in risk, others may elevate the likelihood of developing breast cancer by four- to five-fold. This necessitates a personalized approach to screening and lifestyle optimization for women. The menopausal transition is a critical time for the development of benign breast lesions. Increased detection can be attributed to the heightened precision and utilization of screening mammography, with or without the use of supplemental imaging. While it is widely acknowledged that combined hormone therapy involving estrogen and progesterone may elevate the risk of breast cancer, data from the Women\'s Health Initiative (WHI) indicates that estrogen-alone therapies may actually reduce the overall risk of cancer. Despite this general understanding, there is a notable gap in information regarding the impact of hormone therapy on the risk profile of women with specific benign breast lesions. This review comprehensively examines various benign breast lesions, delving into their pathophysiology and management. The goal is to enhance our understanding of when and how to judiciously prescribe hormone therapy, particularly in the context of specific benign breast conditions. By bridging this knowledge gap, the review provides valuable insights into optimizing healthcare strategies for women with benign breast disease, and offers a foundation for more informed decision-making regarding hormone therapy.
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  • 文章类型: Journal Article
    我们研究了已知影响乳腺癌风险的生殖因素与良性乳腺活检样本中乳腺干细胞标志物CD44、CD24和ALDH1A1表达的相关性。
    我们在护士健康研究(NHS)和NHSII中纳入了439名经活检证实为良性乳腺疾病的无癌女性。有关生殖和其他乳腺癌危险因素的数据来自两年一次的问卷调查。在组织微阵列上进行免疫组织化学(IHC)。对于每个核心,使用半自动平台评估IHC表达,并表示为总细胞计数中特定标志物染色阳性的细胞的百分比。使用广义线性回归来检查生殖因子与每种标志物(在上皮和基质中)的对数转化表达的关联。调整其他乳腺癌风险因素。
    在多变量分析中,初潮与初潮年龄之间的时间与上皮中的CD44呈负相关(β/5年=-0.38,95%CI-0.69;-0.06).初潮和初潮之间的时间与ALDH1A1呈负相关(基质:每5年β=-0.43,95%CI-0.76;-0.10和β=-0.47,95%CI-0.79;-0.15,分别;上皮:β=-0.15,95%CI-0.30;-0.01和β=-0.17,95%CI-0.30;-0.03,分别)。自上次妊娠以来的时间与基质ALDH1A1呈负相关(每5年β=-0.55,95%CI-0.98;-0.11)。没有发现CD24的关联。在绝经前妇女中观察到的关联是相似的。在绝经后的女性中,母乳喂养的终生持续时间与基质ALDH1A1表达呈负相关(β≥24与0至<1个月=-2.24,95%CI3.96;-0.51,p趋势=0.01)。
    早期生殖因素可能影响良性乳腺组织中CD44和ALDH1A1的表达。
    UNASSIGNED: We investigated the associations of reproductive factors known to influence breast cancer risk with the expression of breast stem cell markers CD44, CD24, and ALDH1A1 in benign breast biopsy samples.
    UNASSIGNED: We included 439 cancer-free women with biopsy-confirmed benign breast disease within the Nurses\' Health Study (NHS) and NHSII. The data on reproductive and other breast cancer risk factors were obtained from biennial questionnaires. Immunohistochemistry (IHC) was performed on tissue microarrays. For each core, the IHC expression was assessed using a semi-automated platform and expressed as % of cells that stained positive for a specific marker out of the total cell count. Generalized linear regression was used to examine the associations of reproductive factors with a log-transformed expression of each marker (in epithelium and stroma), adjusted for other breast cancer risk factors.
    UNASSIGNED: In multivariate analysis, the time between menarche and age at first birth was inversely associated with CD44 in epithelium (β per 5 years = -0.38, 95% CI -0.69; -0.06). Age at first birth and the time between menarche and age at first birth were inversely associated with ALDH1A1 (stroma: β per 5 years = -0.43, 95% CI -0.76; -0.10 and β = -0.47, 95% CI -0.79; -0.15, respectively; epithelium: β = -0.15, 95% CI -0.30; -0.01 and β = -0.17, 95% CI -0.30; -0.03, respectively). Time since last pregnancy was inversely associated with stromal ALDH1A1 (β per 5 years = -0.55, 95% CI -0.98; -0.11). No associations were found for CD24. The observed associations were similar in premenopausal women. In postmenopausal women, lifetime duration of breastfeeding was inversely associated with stromal ALDH1A1 expression (β for ≥24 vs. 0 to <1 months = -2.24, 95% CI 3.96; -0.51, p-trend = 0.01).
    UNASSIGNED: Early-life reproductive factors may influence CD44 and ALDH1A1 expression in benign breast tissue.
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  • 文章类型: Journal Article
    背景:良性乳腺疾病(BBD)和高乳腺密度(MBD)是浸润性乳腺癌的流行和独立危险因素。有人认为,MBD的时间变化可能会影响未来的浸润性乳腺癌风险。但尚未在BBD女性中进行研究。
    方法:我们在西北KaiserPermanente的15,395名BBD女性队列中进行了一项巢式病例对照研究(KPNW;1970-2012,随后至2015年中)。病例(n=261)在BBD诊断后>1年发展为浸润性乳腺癌,而对照组(n=249)在病例诊断日期之前没有乳腺癌。病例和对照在BBD诊断年龄和计划成员资格持续时间上进行单独匹配。标准化%MBD变化(每2年),分类为稳定/任何增加(≥0%),最小降幅小于5%或降幅大于或等于5%,从基线和随访乳房X线照片确定。MBD改变与乳腺癌风险之间的关联使用调整的无条件逻辑回归进行检查。
    结果:总体而言,64.5%(n=329)的BBD患者具有非增生性,而35.5%(n=181)的增生性疾病伴/不伴异型性。与MBD降低(≤-5%)的女性相比,MBD降低(赔率比(OR)0.64;95%置信区间(CI)0.38,1.07)的女性患乳腺癌的可能性较小。在诊断为BBD的≥50岁女性(OR0.48;95%CI0.25,0.92)和增殖性BBD(OR0.32;95%CI0.11,0.99)之间的关联更强。
    结论:对时态MBD变化的评估可以为BBD女性的风险监测提供依据,积极降低MBD的策略可能有助于降低未来乳腺癌的风险。
    BACKGROUND: Benign breast disease (BBD) and high mammographic breast density (MBD) are prevalent and independent risk factors for invasive breast cancer. It has been suggested that temporal changes in MBD may impact future invasive breast cancer risk, but this has not been studied among women with BBD.
    METHODS: We undertook a nested case-control study within a cohort of 15,395 women with BBD in Kaiser Permanente Northwest (KPNW; 1970-2012, followed through mid-2015). Cases (n = 261) developed invasive breast cancer > 1 year after BBD diagnosis, whereas controls (n = 249) did not have breast cancer by the case diagnosis date. Cases and controls were individually matched on BBD diagnosis age and plan membership duration. Standardized %MBD change (per 2 years), categorized as stable/any increase (≥ 0%), minimal decrease of less than 5% or a decrease greater than or equal to 5%, was determined from baseline and follow-up mammograms. Associations between MBD change and breast cancer risk were examined using adjusted unconditional logistic regression.
    RESULTS: Overall, 64.5% (n = 329) of BBD patients had non-proliferative and 35.5% (n = 181) had proliferative disease with/without atypia. Women with an MBD decrease (≤ - 5%) were less likely to develop breast cancer (Odds Ratio (OR) 0.64; 95% Confidence Interval (CI) 0.38, 1.07) compared with women with minimal decreases. Associations were stronger among women ≥ 50 years at BBD diagnosis (OR 0.48; 95% CI 0.25, 0.92) and with proliferative BBD (OR 0.32; 95% CI 0.11, 0.99).
    CONCLUSIONS: Assessment of temporal MBD changes may inform risk monitoring among women with BBD, and strategies to actively reduce MBD may help decrease future breast cancer risk.
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