Dietary Patterns and Risk of Breast Cancer in Women in Guilan Province,Iran

Background: Several studies have pointed to roles of dietary and food groups in the pathogenesis of breast cancer, but information on dietary patterns among women with breast cancer and their healthy counterparts in Iran is limited. Therefore the present investigation was conducted in Guilan province in 2014-2015. Materials and Methods: In a case-control study, 450 women with breast cancer and one of their relatives (third-rank) were investigated. At first the phone numbers of patients in Razi Hospital in radiotherapy and chemotherapy and oncology centers of Guilan were taken. Data were collected through telephone interviews by the researcher. The questionnaire had two parts comprising demographic clinical and food frequency data including a list of 40 food items. To analyze the variables, Chi-square test and univariate logistic regression models were used. Results: In each group, 225 subjects were investigated. The majority of samples in both groups of experiment and control were consumed than two glasses of milk and dairy products per day. Regarding consumption of meat and its products, 56% of the cancer group had more than three servings per day while 26.7% of the control group had less than 2 servings per day. The majority of subjects had less than six servings of cereal per day. Some 54. 7 % of the cancer and 62.2 % of the control group consumed less than two servings of fruit per day. Consumption of vegetables in experimental and control groups were 52.9% and 76.9% respectively, more than five servings per day. There was a meaningful difference between two groups regarding the consumption of milk and dairy items (OR=0.6,95%CI= 0.4-0.9), meat and its products (OR=0.49,95%CI=0.3-0.7), bread and cereals (OR=0.4,95%CI=0.2-0.8), vegetables (OR=0.5,95%CI= 0.3-0.9). (P-value<0.05). Conclusions: The results of this study emphasize the importance of informing women, particularly those at higher risk of breast cancer, in relation to dietary factors.     

乳腺癌高危因素

0 引言 乳腺癌已经成为严重威胁女性健康的恶性肿瘤,在西方发达国家发病率较发展中国家高.但随着经济水平不断提高,发展中国家乳腺癌发病率逐年上升,越来越接近欧美等国家.文献报道[1],北京城区1982-2001年间,女性乳腺癌发病率呈逐年上升趋势,平均每年递增4.6%;35～64岁截缩发病率高达95.3/10万.     

云南省妇女乳腺癌危险因子初步研究

目的 研究云南省妇女乳腺癌致癌的危险因子,为乳腺癌的防治提供依据.方法 采用病例对照研究方法,问卷调查1997年1月～2007年4月入院的经病理组织学检查确诊的女性乳腺癌生存病例及同时段年龄相近的非乳腺癌人群.利用SPSS 10.0的logistic回归模型进行数据录入和分析.结果 单因素和多因素分析筛选出有意义的危险因子为:BMI、文化程度、高脂饮食、绝经年龄大、乳腺增生、乳腺癌家族史;保护因子为:月经持续时间、人际关系和精神状况.结论 乳腺癌发病危险因子为:BMI、文化程度、高脂饮食、绝经年龄大、乳腺增生、乳腺癌家族史等,月经持续时间长、较好的人际关系和精神状况等能降低乳腺癌的发病风险.     

Physiological,Reproductive Factors and Breast Cancer Risk in Jiangsu Province of China

To evaluate the relationship between physiological, reproductive factors and risk of breast cancer, weconducted a case-control study with 669 cases and 682 population-based controls in Jiangsu Province of China.A structured questionnaire was used to elicit detailed information. All subjects completed an in-person interview.Unconditional logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidenceintervals (CIs) as measures of risk for breast cancer. The results have revealed that there was an increasing riskof breast cancer, include early age at menarche(≤13 year), late age at menopause(>50 year) and older age at firstpregnancy (≥30 year). Breastfeeding was associated significantly with a reduced risk of breast cancer. Womenwho had history of breastfeeding were at significantly decreased OR (0.44, 95%CI: 0.27-0.73). The protectiveeffects of breastfeeding for breast cancer seemed greater for women who had extended duration of breastfeedingduring their lifetime (p for linear trend: 0.0095). These results suggested that physiological and reproductivefactors may play important roles in the development of breast cancer among Jiangsu’ women of China.     

女性乳腺癌危险因素Meta分析

[目的]运用Meta分析方法综合分析评价中国女性乳腺癌的危险因素。[方法]收集1994-2006年国内有关乳腺癌危险因素的研究文献，采用Meta分析的随机效应模型，计算有关危险因素的OR值及95％CI。[结果]共筛选出相关文献18篇。前5位乳腺癌危险因素及OR值依次为良性乳腺疾病4．87（2．99-6．841、精神创伤3．96（1．87-5．56）、肿瘤家族史3．68（1．51-5．41）、行经时间3．11（1．26～4．89）、哺乳时间2．95（1．42～4．97）。[结论]控制中国人群乳腺癌的发生，应从降低良性乳腺疾病、避免生活精神刺激、提倡母乳喂养和注意高危人群筛检等方面采取有效措施。     

A 10-year Study of Esophageal Cancer in Guilan Province,Iran: The Guilan Cancer Registry Study (GCRS)

Background: Northern Iran counts as one of the highest prevalence regions for esophageal cancer (EC)worldwide. This study was designed to assess the epidemiologic aspects of EC in north central and northwestIran over a 10 year period. Materials and Methods: The Guilan cancer registry study (GCRS) is a populationbasedcancer registry study featuring retrospective (1996-2003) and prospective (2004-2005) phases. A detailedquestionnaire based on WHO standards for cancer registratration was applied to gather the required information.Two trained physicians coded information using ICD-O-3 in close coordination with an expert pathologist. Results:A total of 19,936 cases of malignancy (mean age 55.4±18.0 years, range: 1-98 years) were registered, including1,147 cases (670 males, 447 female; mean age: 64.0±11.5 years) of EC. In 1996 the male/female ratio amongpatients with EC was 1.25 which increased to 1.53 in 2005. The lower third of the esophagus still remained themost common site of tumors. The average age-standardized rate (ASR) was 6.9 and 4.1 per 105 men and women,respectively. In 1996, the ASRs were 7.2 and 5.2 per 105 men and women which decreased to 6.9 and 4.1 per 105 in2004-2005. Squamous cell carcinoma (SCC) was the most prevalent histological subtype of EC accounting over80% of cases. Conclusions: However the prevalence of adenocarcinoma (ADC) showed an increase to 18.4%.Guilan province may be considered a relatively low incidence region for EC.     

Potential Risk Factors for Breast Cancer in Pakistani Women

Background: Breast cancer is the most common female malignancy worldwide and its incidence is on the rise in Pakistan. The aim of this case-control study was to quantify the association of various risk factors with breast cancer risk among Pakistani women. Materials and Methods: A total of 2,246 women were studied, including 1,238 women with histologically confirmed breast cancer patients and age matched control subjects (N1008) without breast cancer and other chronic diseases. Subjects were interviewed using a specifically designed questionnaire. Unconditional logistic regression was applied. Subsequent disease-specific mortality was also measured. Results: In this study, majority of the breast cancer patients (69.59%) were in age ranges of 40s and 50s. BMI greater than 25kg/m2 (OR1.57; 95%CI, 1.26-1.90 and OR1.60; 95%CI, 1.26-2.03), marital status of unmarried (OR2.03; 95%CI, 1.69-2.44), lack of breast feeding, smoking (current or ever), lack of physical activity and post-menopausal status were found to have significant positive associations with breast cancer. It was also observed that increased parity reduced the disease risk. A larger number of cases (58.1%) had their right breast affected while 22.8% had other complications as well. Conclusions: This exploratory analysis indicated a number of risk factors to be associated with increased risk of breast cancer. It was also observed that mean age at diagnosis is a decade earlier than in western countries. It is hoped that our findings will facilitate establishment of adequate evidence-based awareness and preventive measures for Pakistani women.     

Male Breast Cancer: Epidemiology and Risk Factors

Male breast cancer is a rare malignancy that accounts for less than 1% of all cancers in men and less than 1% of all breast cancers. But the incidence is rising and in some patient groups reaching 15% over the course of their lives. The major risk factors for the development of male breast cancer include advancing age, hormonal imbalance, radiation exposure, and a family history of breast cancer. Regarding the latter, incidence can be linked to mutations in high- or low-penetrance genes. The most relevant risk factor for the development of male breast cancer is a mutation in the BRCA2 gene. Most cases present late because of a lack of awareness of the existence of such a malignancy in males and ignorance of the related risk factors. Additionally, males with breast cancer are at special risk for developing a second cancer. This in depth review highlights the epidemiology and risk factors for the development of male breast cancer.     

女性乳腺癌危险因素的病例对照研究

[目的]探讨江苏女性乳腺癌的危险因素。[方法]用病例对照研究的方法,对经病理确诊的206例乳腺癌患者及经年龄频数匹配（±2．5岁）214例对照资料进行非条件Logistic回归分析。[结果]被动吸烟（OR=2．21,95％CI：1．32～3．701、自然流产史（OR=1．71,95％CI：0．65—4．55）、口服避孕药服用史（OR=3．70,95％CI：2．00～6．82）、有良性乳腺疾病史（OR=2．69,95％CI：1．66～4．36）、肥猪肉（OR=2．39,95％CI：1．34～4．28）及腌制类食品年摄入量高（OR=4．71,95％CI：2．91～7．60）、轻体力活动职业（OR=6．29,95％CI：2．95～13．42）可能是女性乳腺癌发生的危险因素。而经常参加体育锻炼（OR=0．44,95％CI：0．26～0．74）、月经初潮年龄晚（OR=0．19,95％CI：0．06—0．65）、鲜奶（0R=0．32,95％CI：0．20～0．511、新鲜豆类（0R=0．07,95％CI：0．04—0．13）和水果年摄入量高（OR=0．30,95％CI：0．18—0．48）则降低乳腺癌发生的风险。[结论]减少口服避孕药、肥猪肉及腌制类食品的摄入,增加新鲜水果、新鲜豆类摄入,加强体育锻炼,对患有良性乳腺疾病的妇女加强体检。加大乳腺癌预防及健康宣教工作可预防乳腺癌的发生。     

Risk Factors for Breast Cancer in Postmenopausal Women in Brazil

Purpose: To analyze risk factors for postmenopausal breast cancer. Methods: The present casecontrol study included 600 women treated at a cancer center reference hospital in a municipality in the South of Brazil. Results: Totals of 100 patients and 500 control subjects were evaluated. The mean age of the women was 52.5 11.9 years; the average was 57.4 11.8 years, and the average age of the control subjects was 51.5 11.7 years. The risk factors for breast cancer that were considered included an age 40 years, postmenopausal status, a body mass index (BMI) 30 kg/m2, and reduced physical activity. Variables like postmenopausal status and an obese BMI were associated with cases of breast cancer. Women who were postmenopausal or obese were 3.80 or 1.80 times more likely to develop breast cancer, respectively, and physically inactive women were 1.72 times more likely to develop breast cancer. Conclusions: Obesity and postmenopausal status are associated with the occurrence of breast cancer in this population. Being over 40 years of age was also a statistically significant factor for postmenopausal women.     

The Relationship of Pre and Early Postnatal Risk Factors with Breast Cancer

Background: Breast cancer (BC) is the most prevalent cancer in Iranian women and the fifth most common cause of cancer-related death in Iran. Risk factors in the adult life may act during fetus life and after delivery. We conducted a case–control study to find out the relation of in utero and early life exposure and risk of BC. Methods: A structured questionnaire that covered demographic criteria and BC risk factors in utero was completed for case (732 cases) and control (584 subjects) groups, matched in terms of demographic variants, reproductive issues and socioeconomic status. Odds ratio (OR) and 95% confidence intervals (CI) were computed as measures of association from the logistic models. Results: Having been breast feed for more than 19-24 month (P<0.001, OR 0.03, CI 0.004-0.21) is protective and positive family history of mother (P-value= 0.009, OR 3.4) is a risk factor for BC in adult. Conclusion: There is increasing recognition that condition in utero is important for later risks in breast. Emerging evidence suggests an association between intrauterine status and women prenatal condition and their subsequent risk of developing breast cancer. this is the first Iranian study assessing prenatal factors and breast cancer risk in the EMR and it should be followed by the larger group of cases and controls in the future.     

Risk Factors for Tamoxifen-Induced Ovarian Hyperstimulation in Breast Cancer Patients

IntroductionAdjuvant endocrine therapy is an integral component of care for hormone-dependent breast cancer. Tamoxifen is a potent inducer of ovarian function and consequent hyperestrogenism in premenopausal women. However, the incidence rate and risk factors associated this phenomenon remain unclear.Patients and MethodsData of patients younger than 60 years who received adjuvant tamoxifen therapy for hormone-dependent breast cancer (stages 0-III) and who underwent regular follow-up of laboratory results for follicle-stimulating hormone and estradiol levels were retrospectively analyzed. Univariate and multivariate analyses were performed to identify clinicopathologic factors related to ovarian hyperstimulation.ResultsAmong 205 patients, 19 (9.3%) showed high values of serum estradiol during tamoxifen therapy. The mean (± SD) serum concentrations of estradiol and follicle-stimulating hormone were 1047.97 ± 638.8 pg/mL and 11.5 ± 7.3 mIU/mL, respectively. A mean of 400.83 days elapsed from the start of the single administration of tamoxifen to the initial detection of a high concentration of estradiol. Univariate and multivariate analyses showed that younger age (< 40 years) and only endocrine therapy without chemotherapy were significantly related to a higher prevalence of ovarian hyperstimulation (P = .015, relative risk = 7.49 for age < 40 years; P = .017, relative risk = 32.9 for no chemotherapy). Pathologic stages and tumor characteristics were not related to the manifestation of ovarian hyperstimulation.ConclusionYoung age (< 40 years) and endocrine treatment without chemotherapy were risk factors for the incidence of ovarian hyperstimulation during tamoxifen treatment. Close monitoring of endocrine parameters during treatment with tamoxifen especially in this patient group is essential.     

Risk Factors for Benign Breast Disease according to Histopathological Type: Comparisons with Risk Factors for Breast Cancer

We evaluated risk factors for benign breast disease by using a case-control study method. The series was taken from participants in breast cancer screening programs during 1978–1986 in Miyagi Prefecture, Japan. All benign breast lesions diagnosed during this period were reviewed and reclassified into proliferative and non-proliferative types based on the Dupont and Page classification. Data on 382 benign breast disease cases (130 proliferative-type cases and 252 non-proliferative-type cases) and 1,489 screening year-, age- and screening area-matched normal controls were used for analysis. Nulliparity or low parity and family history of breast cancer in mother or sisters were significantly associated with an increased risk of proliferative type. Premenopausal status was significantly associated with an increased risk of non-proliferative type. No significant association with history of lactation for the last child was observed in either type, but the risk of proliferative type increased with increasing duration of lactation ( P =0.08). A comparison between the present findings and the risk factors for breast cancer indicated epidemiologic similarities between proliferative benign and malignant breast lesions in general. The associations of these two lesions with lactation patterns were, however, dissimilar.     

晚期乳腺癌脑转移危险因素分析

目的 分析晚期乳腺癌脑转移危险因素,指导临床筛选脑转移高危患者。方法 应用卡方检验及t检验进行单变量分析,对筛选出的脑转移危险因素进行多变量Logistic回归分析。结果 单变量分析显示,肿瘤最长径、阳性淋巴结数目、分子分型、人类表皮生长因子受体2（human epidermalgrowth factor receptor 2,HER2）、辅助化疗、无病生存时间、肺转移、局部复发、淋巴结转移9项因素有统计学意义（P<0.05）。多变量Logistic回归分析显示,术后辅助化疗不标准（P<0.001）、存在肺转移（P=0.003）及HER2阳性（P=0.003）为晚期乳腺癌脑转移的高危因素;所得Logistic回归方程对脑转移的预测正确率为73.9%。结论 晚期乳腺癌脑转移高危因素为术后辅助化疗不标准、存在肺转移及HER2阳性。     

中国女性乳腺癌危险因素的Meta分析

[目的]评价中国女性乳腺癌部分危险因素的作用,探讨乳腺癌的病因。[方法]运用Meta分析方法对我国1996～2006年间公开发表的有关乳腺癌危险因素病例对照研究的12篇文献资料进行定量综合分析。[结果]各因素合并OR值分别为：初潮年龄OR=1．5401（95％CI：1．3437～1．7654）;哺乳OR=0．6837（95％CI：0．4779—0．9782）;口服避孕药OR=1．3278（95％CI：1．0627—1．6589）;良性乳腺疾病史OR=2．6180（95％CI：2．0275—3．3804）;吸烟OR=1．8576（95％CI：1．5394—2．2415）;饮酒OR=0．8137（95％CI：0．6196～1．0686）;饮茶OR=0．8625（95％CI：0．7646～0．9728）。[结论]初潮年龄、口服避孕药、良性乳腺疾病史及吸烟是乳腺癌发生的危险因素,哺乳及饮茶则是乳腺癌的保护因素。     

河南新乡地区女性乳腺癌危险因素的病例对照研究

目的　调查新乡地区女性乳腺癌危险因素 ,为确定高危人群、提出预防措施提供依据。方法　我们从 1992年 4月到 1997年 4月与中国医科院肿瘤医院合作开展了《中国大样本乳腺癌病例对照调查研究》 ,这 5年中对我院就诊的经我院病理证实的乳腺癌30 0例进行病例对照研究。研究其妇科史、药物史、吸烟史及饮食史、家族史、疾病史、染发史等。结果　在单因素分析中 ,达到显著性水平的危险因素为行经期≥ 35年、服用避孕药、良性乳腺疾病史、被动吸烟及常食用蜂王浆等 ,达到显著性水平的保护因素为哺乳及常食豆类食品。条件 (logistic)多元回归分析显示 :重要的有统计学显著意义的乳腺癌危险因素是良性乳腺疾病史、被动吸烟 ;重要保护性因素是常食豆制品及哺乳。结论　新乡地区女性乳腺癌重要危险因素为良性乳腺疾病史及被动吸烟     

Family History Attributes and Risk Factors for Breast Cancer in Turkey

Background: When dealing with breast cancer, early detection is closely associated with determining andclosely monitoring high risk groups. The aim of this study was to determine the preventable risk factors thatare specific for our country, and to understand which risk factors were most predominant. Materials andMethods: The study was planned as a case-control design. Women diagnosed with breast cancer who visitedthe Surgery, Obstetrics and Gynaecology, and Radiation Oncology outpatient clinics of the Izmir Dokuz EylulUniversity (DEU) School of Medicine were accepted as the case group. Then a control group matched for agewas established among females who visited the outpatient clinics on the same days. A questionnaire preparedby the researchers was implemented using a face-to-face interview technique. The Mann-Whitney U test wasused in the comparisons of the group averages, and the Pearson chi-square test in the comparisons betweengroups. In order to determine the dominant risk factors, binary logistical regression test was implemented.Results: A total of 138 patients, 69 cases and 69 controls, were included in the study. A significant difference canbe detected between the groups in terms of BMI, smoking, breast cancer prevalence among first degree familymembers, presence of breast cancer among distant family members, existence of other types of cancers amongfamily members and the age of onset of menopause (p<0.05). Logistical regression analysis revealed that thepresence of breast cancer among first degree relatives increased the risk of developing breast cancer 5.7 times.Conclusions: Although some results of this study are compatible with findings in the literature, some are not. Inorder to determine unique risk factors, there is a clear need for large-scale studies.     

Breast Cancer: Major Risk Factors and Recent Developments in Treatment

Breast cancer is the most common in women worldwide, with some 5-10% of all cases due to inheritedmutations of BRCA1 and BRCA2 genes. Obesity, hormone therapy and use of alcohol are possible causesand over-expression of leptin in adipose tissue may also play a role. Normally surgery, radiation therapy andchemotherapy allow a good prognosis where screening measures are in place. New hope in treatment measuresinclude adjuvant therapy, neoadjuvant therapy, and introduction of mono-clonal antibodies and enzymeinhibitors.     

Systemic Analysis on Risk Factors for Breast Cancer Related Lymphedema

Background: To evaluate risk factors for upper extremity lymphedema due to breast cancer surgery. Materials and Methods: Clinical studies published on PubMed, Ovid, EMbase, and Cochrane Library from January 1996 to December 2012 were selected. Results: Twenty-five studies were identified, including 12,104 patients. Six risk factors related to the incidence of lymphedema after breast cancer treatment were detected: axillary lymph node dissection (OR=3.73, 95%CI 1.16 to 11.96), postoperative complications (OR=2.64, 95%CI 1.10 to 6.30), hypertension (OR=1.83, 95%CI 1.38 to 2.42), high body mass index (OR=1.80, 95%CI 1.30 to 2.49), chemotherapy (OR=1.38, 95%CI 1.07 to 1.79) and radiotherapy (OR=1.35, 95%CI 1.10 to 1.66). We found significant protective factors for lymphedema: pathologic T classification (OR=0.57, 95%CI 0.36 to 0.91) andstage (OR=0.60, 95%CI 0.39 to 0.93), while some factors, like age, number of positive lymph nodes, number of lymph node dissection, demonstrated no obvious correlation. Conclusions: Axillary lymph node dissection, postoperative complications, hypertension, body mass index, chemotherapy, radiotherapy are risk factors for lymphedema after breast cancer treatment. Attention should be paid to patients with risk factors to prevent the occurrence of lymphedema.