PREDICTORS OF BREAST CANCER IN WOMEN RECALLED FOLLOWING SCREENING

Background : Established risk factors are associated with between 25 and 56% of breast cancer cases, but the relative importance and relevance to different age groups is unclear. Methods : This case-control study examines established risk factors in 298 women with breast cancer and 1926 women without breast cancer aged 40–87 who were recalled for assessment following routine mammography. Results : The cancer group were significantly older than the non-cancer group (F_1,222 = 107.6; P < 0.0001). Postmenopausal obesity increased the odds of developing breast cancer (OR: 2.35; CI: 1.33–4.16). The breast cancer group were more likely to have used oral contraceptives (OR: 1.50; CI: 1.09–2.05), and women who used contraceptives for more than 10 years in total were at the highest risk (OR: 1.73; CI: 1.13–2.65). Daily consumption of alcohol was also associated with increased risk of developing breast cancer (OR: 1.62; CI: 1.13–2.33). Reproductive factors and a family history of breast cancer did not affect the odds of developing breast cancer and the reasons for these findings are explored. Conclusions : Results suggest that the effects of weight reduction in reducing postmenopausal breast cancer risk should be assessed.     

The association between induced and spontaneous abortion and risk of breast cancer in Slovenian women aged 25-54

The risk of breast cancer may be increased by induced or spontaneous abortion. The evidence for this association was evaluated in a population based case-control study in Slovenia, where 624 women aged 25-54 years with breast cancer diagnosed during 1988-1990 were matched for age and site of residence with controls randomly selected from the Slovenian Population Registry. Odds ratios (OR) and 95% confidence intervals (CI) were obtained by conditional logistic regression analyses. Spontaneous abortion was not associated with a significantly increased risk of breast cancer (nulliparous women: OR=1.41, 95% CI 0.22-9.01; uniparous women: OR=0.98, 95% CI 0.50-1.91; women with parity 2 or more: OR=1.40, 95% CI 0.91-2.15). Induced abortion was not associated with a statistically significant elevated risk. The risk of breast cancer was higher in nulliparous women (OR=2.49, 95% Cl 0.68-9.09), and was less among women who had more deliveries. In uniparous women, the risk of breast cancer appeared higher when the induced abortion took place before a first full-term pregnancy (OR=1.94, 95% CI 0.70-5.39) rather than after a first full-term pregnancy (OR=1.22, 95% CI 0.71-2.10) but neither of these odds ratios reached significance. We found no significant association between spontaneous abortion or induced abortion and breast cancer risk. This study found an elevated, but not statistically significant, risk associated with induced abortion among nulliparous women and among parous women when the induced abortion was before the first full-term pregnancy.     

Parity in relation to risk of axillary lymph node involvement in women with breast cancer. Results from Swedish population-based series of 3,472 consecutive cases

OBJECTIVE: To investigate the association between parity and axillary lymph node involvement (ALNI) at breast cancer diagnosis. METHODS: One surgeon has reviewed all breast cancer cases in Malmo, Sweden, diagnosed 1961-1991. This study includes the 3,472 women who had a first-time diagnosis of unilateral invasive breast cancer, and who had undergone axillary dissection. Information was collected regarding date of birth, date of diagnosis, age at diagnosis, menopausal status, tumour size, histological type, tumour location, type of surgery, stage (ALNI), and parity. Parity was investigated in relation to ALNI using logistic regression analysis, adjusted for potential confounders, yielding odds ratios (OR) with 95% confidence intervals (CI). The analyses were repeated in different strata with regard to birth-years cohort, age at diagnosis, and period of diagnosis. RESULTS: High parity was associated with ALNI, the adjusted OR for ALNI among women with 4 or more children was 1.56 (1.13-2.15). This association was stronger in comparatively old women (> or = 67.45 years), OR 1.78 (1.10-2.88). Considering parity a continuous variable, the OR for ALNI among all women was 1.06 (1.01-1.12). CONCLUSIONS: We conclude that women with 4 or more children had an increased risk of ALNI at breast cancer diagnosis.     

Anthropometry and breast cancer risk in Nigerian women

The recent upsurge in global obesity and the recognition of the role of metabolic syndrome and other correlates of obesity in the etiology of breast cancer and other chronic diseases has created the impetus for renewed interest in the role of anthropometric measures in breast cancer risk. This case-control study was designed to evaluate the role of anthropometric variables in breast cancer susceptibility in an indigenous sub-Saharan African population drawn from midwestern and southeastern Nigeria, a population grossly underreported in the global epidemiologic literature. Study participants were 250 women with breast cancer who were receiving treatment in the surgical outpatient clinics and surgical wards of four university teaching hospitals located in midwestern and southeastern Nigeria, while the controls were 250 age-matched women without breast cancer or other malignant diseases being treated for other surgical diseases in the same institutions between September 2002 and April 2004. Waist:hip ratio (WHR) was associated with a significant 2.5-fold increased risk of premenopausal breast cancer (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.48-4.41] and a 2-fold increased risk of postmenopausal breast cancer (OR = 2.00, 95% CI 1.04-2.53). Increasing height conferred a modestly nonsignificant increased risk of premenopausal breast cancer (OR = 1.59, 95% CI 0.98-2.58). The study showed that WHR is a significant predictor of breast cancer risk in Nigerian women and measures to sustain increased physical activity and ensure healthy dietary practices are recommended to reduce the burden of obesity in the population.     

Genetic polymorphisms of CYP1A1, CYP2E1, GSTM1, and GSTT1 associated with head and neck cancer

BACKGROUND: Alcohol intake and tobacco smoke, in addition to other environmental and genetic factors, have been associated with head and neck cancer. We evaluated the role of metabolic enzyme polymorphisms on the risk of head and neck cancer in a hospital-based case-control study. METHODS: CYP1A1MspI, CYP2E1PstI, GSTM1, and GSTT1polymorphisms were evaluated in 103 histologically confirmed head and neck cancer cases and 102 controls by means of polymerase chain reaction-restriction fragment length polymorphism methods. RESULTS: GSTM1null increased the risk of head and neck cancer (odds ratio [OR], 2.2; 95% confidence interval [95% CI], 1.24-3.79), oral cancer (OR, 2.8; 95% CI, 1.28-5.98), and pharyngeal cancer (OR, 2.2; 95% CI, 1.08-4.63). CYP2E1PstI polymorphism indicated a risk for oral cancer (OR, 3.6; 95% CI, 1.29-11.56). The joint effect of GSTM1 null and CYP1A1 polymorphism increased the risk of head and neck cancer (OR, 2.4; 95% CI, 1.13-5.10). CONCLUSIONS: GSTM1 null alone or associated with CYP1A1 increased the risk of head and neck cancer; the CYP2E1PstI mutated allele increased the risk for only oral cancer.     

Association between body mass index and risk of formation of breast cancer in Chinese women

OBJECTIVE: To analyse the association between body mass index (BMI) and breast cancer risk among Chinese women in Hong Kong. METHODS: We conducted a population-based case control study of breast cancer in June 2002. Standardized questionnaires concerning BMI and other anthropometric data were completed by patients at the Queen Mary Hospital (QMH). The cases were 198 women aged 24-85 years who had documented breast cancer in 1995-2000 by triple assessment criteria, and the controls were 353 women who were followed up at QMH for benign breast disease after breast cancer had been excluded by triple assessment. The controls were frequency-matched to the cases by age. RESULTS: BMI at diagnosis was positively correlated with the risk of breast cancer among postmenopausal women (p < 0.001 for trend). Also, when compared with women with a low BMI (< 19), women with a BMI of 23-27 and 27-31 had a 1.73-fold (95% confidence interval, CI, 1.04-2.86) and 2.06-fold (95% CI, 1.08-3.93) increased risk of breast cancer, respectively, after adjustment for non-anthropometric risk factors. BMI at diagnosis, however, was not related to the risk of breast cancer among premenopausal women. The odds ratios for premenopausal women with a BMI of 23-27 and 27-31 were 1.5 (95% CI, 0.82-2.71) and 1.32 (95% CI, 0.39-4.43), respectively. Furthermore, present BMI and BMI 5 years before diagnosis were poorly associated with breast cancer risk among both pre- and postmenopausal women. CONCLUSION: Weight control in obese women may be an effective measure for breast cancer prevention in postmenopausal women.     

Predictors of Breast Cancer Development in Women with Atypical Ductal Hyperplasia and Atypical Lobular Hyperplasia

Background

Atypical ductal hyperplasia and atypical lobular neoplasia are common benign breast diseases that increase breast cancer risk. We performed a cohort analysis that compared atypia patients for additional risk factors to asses the effect on breast cancer risk by atypia status.

Methods

This longitudinal cohort study used data from the Women At Risk High-Risk Registry at Columbia University Medical Center, New York. Women with atypia were compared to women without atypia across known risk factors to determine the combined effect on breast cancer development. Odds ratios (ORs) stratified by atypia status were calculated for each risk factor of interest with 95% confidence intervals (95% CIs). P values were calculated to determine statistical significance.

Results

The study population included 1598 high-risk women, 921 (57.6%) of whom had a history of biopsy-proven atypia. The remaining 677 high-risk women (42.4%) did not have atypia. Fifty women (3.1%) developed breast cancer. Alcohol was significantly associated with the development of breast cancer (P = 0.02) and increased breast cancer risk among women with atypia (OR, 2.13; 95% CI, 0.95–4.81) compared to women without atypia (OR, 1.71). The odds of breast cancer were higher for atypia patients with first-degree relatives (OR, 1.48; 95% CI, 0.64–3.35) compared to women with a relative and no atypia diagnosis (OR, 0.98; 95% CI, 0.41–2.63). The other risk factors of interest did not differ significantly by atypia status.

Conclusions

Atypia patients who drank alcohol and had a first-degree relative with breast cancer have an increased risk of breast cancer compared to those without atypia. Continued understanding of the high-risk population will lead to more individualized protocols for risk reduction and prevention.     

Patterns of care analysis among women with ductal carcinoma in situ in North Carolina

BACKGROUND: Ductal carcinoma in situ (DCIS) of the breast comprises approximately 25% of new breast cancer cases. The aim of this study was to delineate patterns of care for women with DCIS as related to age, tumor characteristics, and race/ethnicity. Further study goals included the identification of predictors of breast-conserving surgery (BCS), adjuvant radiation, and/or hormonal therapy, as well as breast reconstruction after mastectomy. METHODS: The North Carolina Cancer Registry was queried for primary DCIS treated in 1998 and 1999 (n = 1,893). Logistic regression analysis was performed to define the determinants of patterns of care. RESULTS: Thirty-five percent of the women in this study sample underwent mastectomy. Positive predictors of mastectomy included young age (age <50 y vs 70+; odds ratio [OR], 1.55; 95% confidence interval [CI], 1.13-2.11) and larger tumor size (>2 mm vs 0-1 mm; OR, 2.43; 95% CI, 1.63-3.60). Approximately 48% of women who underwent BCS received adjuvant radiation therapy. Factors associated with receiving radiation therapy after BCS include younger age (age <50 vs 70+; OR, 2.12; 95% CI, 1.49-3.03). Approximately 19% of women who underwent BCS received adjuvant hormonal therapy. Positive predictors of receiving adjuvant hormonal therapy after BCS included age of 50 to 60 years versus 70+ (OR, 2.16; 95% CI, 1.36-3.44) and the receipt of radiation therapy (OR, 3.60; 95% CI, 2.55-5.06). Approximately 28% of women who underwent mastectomy received breast reconstruction surgery. Positive predictors of breast reconstruction after mastectomy included age younger than 50 years versus 70+ years (OR, 47.36; 95% CI, 19.45-115.32). African American race was associated negatively with receipt of breast reconstruction after mastectomy (OR, .46; 95% CI, .26-.84). CONCLUSIONS: Treatment strategies for primary surgical therapy for DCIS vary significantly by age. Inconsistencies exist surrounding the use of adjuvant radiation therapy after BCS in women with DCIS. Variations in approaches to reconstructive surgery after mastectomy may be related to age, ethnicity, and/or economic constraints.     

Low Bone Mineral Density in Middle-Aged Breast Cancer Survivors: Prevalence and Associated Factors

BACKGROUND: The aim of this study was to investigate the prevalence of low bone mineral density (BMD) and associated factors in middle-aged breast cancer survivors (BCS). PATIENTS AND METHODS: A cross-sectional study was conducted with 70 BCS of 45-65 years of age undergoing complete oncology treatment. Logistic regression models were used to identify factors associated with low BMD (osteopenia and osteoporosis taken together as a single group). RESULTS: The mean age of participants was 53.2 ± 5.9 years. BMD was low at the femoral neck in 28.6% of patients and at the lumbar spine in 45.7%. Body mass index ≤ 30 kg/m(2) (adjusted odds ratio (OR) 3.43; 95% confidence interval (CI) 1.0-11.3) and postmenopausal status (OR adjusted 20.42; 95% CI 2.0-201.2) were associated with low BMD at the lumbar spine. Femoral neck measurements, age > 50 years (OR 3.41; 95% CI 1.0-11.6), and time since diagnosis > 50 months (OR adjusted 3.34; 95% CI 1.0-11.3) increased the likelihood of low BMD. CONCLUSION: These findings show that low BMD is common in middle-aged BCS. Factors were identified that may affect BMD in BCS and should be considered when implementing strategies to minimize bone loss in middle-aged women with breast cancer.     

Risk factors for estrogen receptor positive ductal carcinoma in situ of the breast in African American women

BackgroundCompared to U.S. white women, African American women are more likely to die from ductal carcinoma in situ (DCIS). Elucidation of risk factors for DCIS in African American women may provide opportunities for risk reduction.MethodsWe used data from three epidemiologic studies in the African American Breast Cancer Epidemiology and Risk Consortium to study risk factors for estrogen receptor (ER) positive DCIS (488 cases; 13,830 controls). Results were compared to associations observed for ER+ invasive breast cancer (n = 2,099).ResultsFirst degree family history of breast cancer was associated with increased risk of ER+ DCIS [odds ratio (OR): 1.69, 95% confidence interval (CI): 1.31, 2.17]. Oral contraceptive use within the past 10 years (vs. never) was also associated with increased risk (OR: 1.43, 95%CI: 1.03, 1.97), as was late age at first birth (≥25 years vs. <20 years) (OR: 1.26, 95%CI: 0.96, 1.67). Risk was reduced in women with older age at menarche (≥15 years vs. <11 years) (OR: 0.62, 95%CI: 0.42, 0.93) and higher body mass index (BMI) in early adulthood (≥25 vs. <20 kg/m² at age 18 or 21) (OR: 0.75, 95%CI: 0.55, 1.01). There was a positive association of recent BMI with risk in postmenopausal women only. In general, associations of risk factors for ER+ DCIS were similar in magnitude and direction to those for invasive ER+ breast cancer.ConclusionsOur findings suggest that most risk factors for invasive ER+ breast cancer are also associated with increased risk of ER+ DCIS among African American women.     

p53、CYP1A1、GSTM1多态性组合和吸烟对前列腺癌风险的联合效应:基因型和环境相互作用的探测性研究

目的:评估若干遗传学因素与一个环境因素对患前列腺癌风险的联合调节作用。本文重点关注与细胞调控有关的低外显基因的等位变体、解毒过程和吸烟这几个因素。方法:本研究设了病例对照。研究分析了携 p53cd72 Pro 等位基因、CYP1A1 M1等位基因和 GSTM1 null 基因型的人群与他们患前列腺癌的风险之间的关联。结果:携 Pro~*和 M1~*,Pro~*和 GSTM1null 或 GSTM1 null 和 CYP1A1 M1~*等位变体的吸烟者的联合患病风险显著高于对照组(优势比[odds ratio:OR]:13.13,95%置信区间[CI]:2.41-71.36;OR:3.97,95% CI:1.13-13.95;OR:6.87,95% CI:1.68-27.97),非吸烟组的患病风险与对照组相比无显著差异。与非吸烟者和无患病风险组相比,p53cd72,GSTM1和 CYP1A1 M1在吸烟者中的组合极明显地与前列腺癌患病风险有关联(OR:8.87,95% CI:1.25-62.71)。结论:本文实验结果表明,在研究人群中,p53cd72,CYP1A1和GSTM1等位基因与吸烟因素的组合对前列腺癌患病风险的改变起重要作用,这意味着携敏感基因型的吸烟者可能比携带非敏感基因型的吸烟者患前列腺癌的风险更大。     

Mammographic breast density in recent and longer‐standing ethiopian immigrants to israel

High breast density is associated with an increased risk of breast cancer development. Little is known concerning ethnic variations in breast density and its relevant contributing factors. We aimed to study breast density among Ethiopian immigrants to Israel in comparison with Israeli‐born women and to determine any effect on breast density of the length of residency in the immigrant population. Mammographic breast density using the BI‐RADS system was estimated and compared between 77 women of Ethiopian origin who live in Israel and 177 Israeli‐born controls. Logistic regression analysis was performed to estimate the odds ratios (OR) for high density (BI‐RADS score ≥ 3) vs low density (BI‐RADS score < 3) cases, comparing the 2 origin groups. Ethiopian‐born women had a crude OR of 0.15 (95% CI: 0.08‐0.26) for high breast density compared with Israeli‐born women. Adjustments for various cofounders did not affect the results. Time since immigration to Israel seemed to modify the relationship, with a stronger association for women who immigrated within 2 years prior to mammography (OR:0.07, 95% CI: 0.03‐0.17) as opposed to women with a longer residency stay in Israel (OR:0.23, 95% CI:0.10‐0.50). Adjustments of various confounders did not alter these findings. Breast density in Ethiopian immigrants to Israel is significantly lower than that of Israeli‐born controls. Our study suggests a positive association between time since immigration and breast density. Future studies are required to define the possible effects of dietary change on mammographic density following immigration.     

Joint effect among p53, CYP1A1, GSTM1 polymorphism combinations and smoking on prostate cancer risk： an exploratory genotype-environment interaction study

Aim： To assess the role of several genetic factors in combination with an environmental factor as modulators of prostate cancer risk. We focus on allele variants of low-penetrance genes associated with cell control, the detoxification processes and smoking. Methods： In a case-control study we compared people carrying p53cd72 Pro allele, CYP1A1 M1 allele and GSTM1 null genotypes with their prostate cancer risk. Results： The joint risk for smokers carrying Pro^＊ and MI^＊, Pro^＊ and GSTM1null or GSTM1 null and CYP1A1 MI^＊ variants was significantly higher （odds ratio [OR]： 13.13, 95% confidence interval [CI]： 2.41-71.36; OR： 3.97, 95% CI： 1.13-13.95 and OR： 6.87, 95% CI： 1.68-27.97, respectively） compared with that for the reference group, and for non-smokers was not significant. OR for combinations among p53cd72, GSTM1 and CYP1A1 M1 in smokers were positively and significantly associated with prostate cancer risk compared with non-smokers and compared with the putative lowest risk group （OR： 8.87, 95% CI： 1.25-62.71）. Conclusion： Our results suggest that a combination of p53cd72, CYP1A1, GSTM1 alleles and smoking plays a significant role in modified prostate cancer risk on the study population, which means that smokers carrying susceptible genotypes might have a significantly higher risk than those carrying non-susceptible genotypes.     

Factors associated with breast MRI use among women with a family history of breast cancer

Although annual breast magnetic resonance imaging (MRI) is recommended for women at high risk for breast cancer as an adjunct to screening mammography, breast MRI use remains low. We examined factors associated with breast MRI use in a cohort of women with a family history of breast cancer but no personal cancer history. Study participants came from the Sister Study cohort, a nationwide, prospective study of women with at least 1 sister who had been diagnosed with breast cancer but who themselves had not ever had breast cancer (n = 17 894). Participants were surveyed on breast cancer beliefs, cancer worry, breast MRI use, provider communication, and genetic counseling and testing. Logistic regression was used to assess factors associated with having a breast MRI overall and for those at high risk. Breast MRI was reported by 16.1% and was more common among younger women and those with higher incomes. After adjustment for demographics, ever use of breast MRI was associated with actual and perceived risk. Odds ratios (OR) were 12.29 (95% CI, 8.85‐17.06), 2.48 (95% CI, 2.27‐2.71), and 2.50 (95% CI, 2.09‐2.99) for positive BRCA1/2 test, lifetime breast cancer risk ≥ 20%, and being told by a health care provider of higher risk, respectively. Women who believed they had much higher risk than others or had higher level of worry were twice as likely to have had breast MRI; OR = 2.23 (95% CI, 1.82‐2.75) and OR = 1.76 (95% CI, 1.52‐2.04). Patterns were similar among women at high risk. Breast cancer risk, provider communication, and personal beliefs were determinants of breast MRI use. To support shared decisions about the use of breast MRI, women could benefit from improved understanding of the chances of getting breast cancer and increased quality of provider communications.     

Risk factors for surgical site infection after major breast operation

BACKGROUND: Understanding surgical site infection (SSI) risk factors after breast operation is essential to develop infection-prevention strategies and improve surgical outcomes. METHODS: We performed a retrospective case-control study with subjects selected from a cohort of mastectomy, breast reconstruction, and reduction surgical patients between January 1998 and June 2002 at a university-affiliated hospital. SSI cases within 1 year after operation were identified using ICD-9-CM diagnosis codes for wound infection and complication or positive wound cultures, or both. Medical records of 57 patients with breast SSI and 268 randomly selected uninfected control patients were reviewed. Multivariate logistic regression was used to identify independent risk factors for SSI. RESULTS: Significant independent risk factors for breast incisional SSI included insertion of a breast implant or tissue expander (odds ratio [OR] = 5.3; 95% CI, 2.5 to 11.1), suboptimal prophylactic antibiotic dosing (OR = 5.1; 95% CI, 2.5 to 10.2), transfusion (OR = 3.4; 95% CI, 1.3 to 9.0), mastectomy (OR = 3.3; 95% CI, 1.4 to 7.7), previous chest irradiation (OR = 2.8; 95% CI, 1.2 to 6.5), and current or recent smoking (OR = 2.1; 95% CI, 0.9 to 4.9). Local infiltration of an anesthetic agent was associated with substantially reduced odds of SSI (OR = 0.4; 95% CI, 0.1 to 0.9). CONCLUSIONS: Suboptimal prophylactic antibiotic dosing is a potentially modifiable risk factor for SSI after breast operation. SSI risk was increased in patients undergoing mastectomy and in patients who had an implant or tissue expander placed during operation. This information can be used to develop a specific risk stratification index to predict SSI and infection-preventive strategies tailored for breast surgery patients.     

Environmental, occupational and familial risks for testicular cancer: a hospital-based case-control study

Testicular cancer (TC) risk factors remain largely unknown, except for personal history of cryptorchidism and familial history of TC. We conducted a hospital-based case-control study on familial, environmental and occupational conditions in which we compared 229 cases and 800 controls. TC was correlated with cryptorchidism (OR = 3.02; CI: 1.90-4.79), a history of cryptorchidism in relatives (OR = 2.85; CI: 1.70-4.79), and TC (OR = 9.58; CI: 4.01-22.88], prostate cancer (OR = 1.80; CI: 1.08-3.02) and breast cancer (OR = 1.77; CI: 1.20-2.60) in relatives. Living in a rural area or having regular gardening activity (growing fruit or vegetables) was associated with an increased risk of TC (OR = 1.63; CI: 1.16-2.29; OR = 1.84; CI: 1.23-2.75). Regarding occupation, we found a relationship with employment in metal trimming (OR = 1.96; CI: 1.00-3.86), chemical manufacture (OR = 1.88; CI: 1.14-3.10), industrial production of glue (OR = 2.21; CI: 1.15-4.25), and welding (OR = 2.84; CI: 1.51-5.35). In a multivariate model, only a history of cryptorchidism in the men, cryptorchidism in relatives, TC, and breast cancer remained significant. Our findings contribute further evidence to a pattern of TC risk factors, which include the significant weight of personal reproductive history and also of testicular and breast cancer in relatives. By including in a multivariate model variables linked to environmental and occupational exposure and related to familial cancer history, neither living in a rural area nor any occupational exposure appeared to be a potential environmental TC risk factor.     

Lack of association of ADH1C genotype with breast cancer susceptibility in Caucasian population: a pooled analysis of case-control studies

PurposeRecent epidemiological studies demonstrated that alcohol dehydrogenase 1C (ADH1C) alleles that result in acetaldehyde accumulation in the cells can enhance a drinker’s risk of developing alcohol related cancer in a variety of tissues. The published data on the association between ADH1C alleles and breast cancer occurrence in Caucasians have led to in contradictory results. This meta-analysis of literatures was performed to derive a more precise estimation of the relationship.MethodsA total of 12 studies were identified to the meta-analysis, including 6159 cases and 5732 controls from Caucasians. The pooled odds ratio (OR) with 95% confidence interval (CI) for breast cancer risk associated with ADH1C genotype was estimated.ResultsOverall, no significantly elevated breast cancer risk was found in all genetic models when all studies were pooled into the meta-analysis (ADH1C^1-2 vs. ADH1C^2-2: OR 1.07, 95% CI 0.97–1.19; ADH1C^1-1 vs. ADH1C^2-2: OR 1.16, 95% CI 0.94–1.43; dominant model: OR 1.07, 95% CI 0.97–1.18; recessive model: OR 1.06, 95% CI 0.93–1.20). There was no evidence for the association between ADH1C genotype and breast cancer risk in subgroup analyses based on design of experiment and menopausal status. And for the additive model, individuals carrying the ADH1C*¹ allele were not significantly associated with increased risk to breast cancer (OR 1.01, 95% CI 0.97–1.06).ConclusionThis meta-analysis suggests that ADH1C polymorphism may not be associated with breast cancer development in Caucasians. And larger scale primary studies are required to further evaluate the interaction of ADH1C polymorphism and breast cancer risk in specific populations.     

A case-control study of breast cancer and dietary intake of individual fatty acids and antioxidants in Montreal, Canada

This case-control study was conducted among French-Canadians to assess the association between breast cancer risk and specific fatty acids, and to investigate if breast cancer risk associated with individual polyunsaturated fatty acids differs in regard to antioxidant intakes. A total of 414 cases and 429 population-based controls were interviewed between 1989 and 1993. Dietary intake was assessed by a food-frequency questionnaire. No overall association was found between specific fatty acids and breast cancer risk, after adjustment for risk factors and total energy intake. In postmenopausal women with low vitamin E intake, there was an inverse and dose-dependent relationship between arachidonic acid and breast cancer risk [odds ratio (OR)=0.41; 95% confidence interval (CI) (0.20-0.82); P=0.02], while those with high vitamin E intake exhibited a significantly elevated risk [OR=2.46; 95% CI (1.12-5.39); P=0.024] when comparing the upper to the lower quartiles. The possible role of the interaction effect between arachidonic acid and vitamin E in breast cancer risk requires further investigation.     

The Role of Preoperative Magnetic Resonance Imaging in the Assessment and Surgical Treatment of Interval and Screen‐Detected Breast Cancer in Older Women

We describe the relationship between preoperative magnetic resonance imaging (MRI) and the utilization of additional imaging, biopsy, and primary surgical treatment for subgroups of women with interval versus screen‐detected breast cancer. We determined the proportion of women receiving additional breast imaging or biopsy and type of primary surgical treatment, stratified by use of preoperative MRI, separately for both groups. Using Breast Cancer Surveillance Consortium (BCSC) data, we identified a cohort of women age 66 and older with an interval or screen‐detected breast cancer diagnosis between 2005 and 2010. Using logistic regression, we explored associations between primary surgical treatment type and preoperative MRI use for interval and screen‐detected cancers. There were 204 women with an interval cancer and 1,254 with a screen‐detected cancer. The interval cancer group was more likely to receive preoperative MRI (21% versus 13%). In both groups, women receiving MRI were more likely to receive additional imaging and/or biopsy. Receipt of MRI was not associated with increased odds of mastectomy (OR = 0.99, 95% CI: 0.67–1.50), while interval cancer diagnosis was associated with significantly higher odds of mastectomy (OR = 1.64, 95% CI: 1.11–2.42). Older women with interval cancer were more likely than women with a screen‐detected cancer to have preoperative MRI, however, those with an interval cancer had 64% higher odds of mastectomy regardless of receipt of MRI. Given women with interval cancer are reported to have a worse prognosis, more research is needed to understand effectiveness of imaging modalities and treatment consequences within this group.     

Risk Factors for Breast Cancer: A Case-Control Study from Taegu, Korea

Abstract: A hospital-based case-control study was carried out to identify reproductive risk factors for breast cancer in Taegu, Korea. Four hundred and eighty-one breast cancer patients and 491 age-matched control patients examined between 1988 and 1994 were included in this study. Eleven reproductive risk factors were selected for comparison using cross tabulation and chi-square method, and univariate and multivariate logistic regression analyses were used to evaluate the odds ratios for the risk of breast cancer. The mean age of the breast cancer patients in this study was 47.5 years. Analyses demonstrated that nulliparous women had a higher risk for breast cancer (odds ratio 3.46, p = 0.03) than women with one to four live births, and women who had an abortion during their first pregnancy had a slightly increased risk (odds ratio 1.86, p < 0.01) than women who had normal deliveries, but the age at menarche and menopause did not have any influence on the risk of developing breast cancer. Although there were similarities in risk factors between Western women and women in this study, such as a higher risk for nulliparous women, two key factors were found to contrast with those of Western women. First, the mean age of breast cancer patients in this study was only 47.5 years. Second, the age of menarche and menopause of these women did not have any influence on the risk of breast cancer.