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Reproductive Variables and Risk of Breast Malignant and Benign Tumours in Yunnan Province, China

  • Yanhua, Che (Breast Department, The First Peoples' Hospital of Kunming) ;
  • Geater, Alan (Epidemiology Unit, Faculty of Medicine, Prince of Songkla University) ;
  • You, Jing (Department of Infectious Diseases, The First Affiliated Hospital of Kunming Medical University) ;
  • Li, Li (Breast Department, The First Peoples' Hospital of Kunming) ;
  • Shaoqiang, Zhou (The Department of Breast Cancer, The Tumor Hospital of Yunnan province) ;
  • Chongsuvivatwong, Virasakdi (Epidemiology Unit, Faculty of Medicine, Prince of Songkla University) ;
  • Sriplung, Hutcha (Epidemiology Unit, Faculty of Medicine, Prince of Songkla University)
  • Published : 2012.05.30

Abstract

Introduction and aim: To compare reproductive factor influence on patients with pathological diagnosed malignant and benign tumor in the Breast Department, The First Peoples' Hospital of Kunming in Yunnan province, China. Methods: A hospital-based case-control study was conducted on 263 breast cancer (BC) cases and 457 non-breast cancer controls from 2009 to 2011. The cases and controls information on demographics, medical history, and reproductive characteristics variables were collected using a self-administered questionnaire and routine medical records. Histology of breast cancer tissue and benign breast lesion were documented by pathology reports. Since some variables in data analysis had zero count in at least one category, binomial-response GLM using the bias-reduction method was applied to estimate OR's and their 95% confidence intervals (95% CI). To adjust for age and menopause status, a compound variable comprising age and menopausal status was retained in the statistical models. Results: multivariate model analysis revealed significant independent positive associations of BC with short menstrual cycle, old age at first live birth, never breastfeeding, history of oral contraception experience, increased number of abortion, postmenopausal status, and nulliparity. Categorised by age and menopausal status, perimenopausal women had about 3-fold and postmenopausal women had more than 5-fold increased risk of BC compared to premenopausal women. Discussion and Conclusion: This study has confirmed the significant association of BC and estrogen related risk factors of breast cancer including longer menstrual cycle, older age of first live birth, never breastfeeding, nulliparity, and number of abortions more than one. The findings suggest that female hormonal factors, especially the trend of menopause status play a significant role in the development of BC in Yunnan women.

Keywords

References

  1. Collaborative Group on Hormonal Factors in Breast Cancer (2002). Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet, 360, 187-95. https://doi.org/10.1016/S0140-6736(02)09454-0
  2. Collaborative Group on Hormonal Factors in Breast Cancer (2004). Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83 000 women with breast cancer from 16 countries., Lancet, 363, 1007-16. https://doi.org/10.1016/S0140-6736(04)15835-2
  3. WHO expert consultation (2004). www.thelancet.com. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies, Lancet, 363, 157-63. https://doi.org/10.1016/S0140-6736(03)15268-3
  4. Cancer Incidence in Five Continents Volumes IX (2007) age specific table. IARC.
  5. Bjelic-Radisic V, Petru E (2010). Hormonal contraception and breast cancer risk. Wien Med Wochenschr, 160, 483-6. https://doi.org/10.1007/s10354-010-0807-0
  6. Britt K, Ashworth A, et al (2007). Pregnancy and the risk of breast cancer. Endocr Relat Cancer, 14, 907-33. https://doi.org/10.1677/ERC-07-0137
  7. Bulun SE, Lin Z, et al (2009). Regulation of aromatase expression in breast cancer tissue. Ann N Y Acad Sci, 1155, 121-31. https://doi.org/10.1111/j.1749-6632.2009.03705.x
  8. Chantal C Orgeas, Per Hall, et al (2008). The influence of menstrual risk factors on tumor characteristics and survival in postmenopausal breast cancer. Breast Cancer Res, 10, 107. https://doi.org/10.1186/bcr2107
  9. Chen H, Feng YJ, et al (2010). Survey on menopausal age and menstruation span in women in Pudong district of Shanghai. Zhonghua Fu Chan Ke Za Zhi, 45, 415-9.
  10. Colditz GA, Baer HJ, et al (2006). Breast Cancer. In: Schottenfeld D, Fraumeni JF Jr. (eds) New York, Oxford University Press.
  11. Firth D (1993). Bias reduction of maximum likelihood estimate. Biostatistics, 80, 27-38.
  12. Friedenreich CM, Cust AE (2008). Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects. Br J Sports Med, 42, 636-47. https://doi.org/10.1136/bjsm.2006.029132
  13. Galobardes B, Shaw M, et al (2006). Indicators of socioeconomic position (part 1). J Epidemiol Community Health, 60, 7-12. https://doi.org/10.1136/jech.2004.023531
  14. Goldman MB, Hatch MC (2000). Breast cancer epidemology, treatment, and prevention. In: Ursin G, Spicer D (Eds) Women and Health. London: Academic Press: 871-883.
  15. Hankinson SE, Colditz GA, et al (2004). Towards an integrated model for breast cancer etiology: the lifelong interplay of genes, lifestyle, and hormones. Breast Cancer Res, 6, 213-8. https://doi.org/10.1186/bcr921
  16. Heuch I, Jacobsen BK, et al (2008). Reproductive factors and pancreatic cancer risk: a Norwegian cohort study. Br J Cancer, 98, 189-93. https://doi.org/10.1038/sj.bjc.6604095
  17. IARC (2008) Breast Cancer Incidence and Mortality Worldwide in 2008 Summary. GLOBOCAN 2008 Retrieved October 29, 2011, from http://globocan.iarc.fr/factsheets/cancers/breast.asp
  18. Ioannis. (2007) brglm: Bias reduction in binary-response GLMs. Kosmidis.
  19. Kruk J (2007). Lifetime physical activity and the risk of breast cancer:A case-control study. Cancer Detection & Prev, 31, 18-28. https://doi.org/10.1016/j.cdp.2006.12.003
  20. Kabat GC, Kim MY, et al (2011). Reproductive and menstrual factors and risk of ductal carcinoma in situ of the breast in a cohort of postmenopausal women. Cancer Causes Control, 22, 1415-24. https://doi.org/10.1007/s10552-011-9814-8
  21. Key TJ (1995 ). Hormones and cancer in humans. Mutat Res, 333, 59-67. https://doi.org/10.1016/0027-5107(95)00132-8
  22. Lacey JV Jr, Kreimer AR, ONE AUTHOR, et al (2009). Breast cancer epidemiology according to recognized breast cancer risk factors in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Cohort. BMC Cancer, 9, 84.
  23. Lee C, Ko I S, et al (2004). Development and validation study of the breast cancer risk appraisal for Korean women. Nurs Health Sci, 6, 201-7. https://doi.org/10.1111/j.1442-2018.2004.00193.x
  24. Leong SP, Shen ZZ, et al (2010). Is breast cancer the same disease in Asian and Western countries? World J Surg, 34, 2308-24. https://doi.org/10.1007/s00268-010-0683-1
  25. Li N, He M (2006). Breast cancer genetic epidemiology study and conditional logistic regression analysis of relative risk factors of female in hospital in Liaoning province. Chin J Cancer Prev Treat, 13, 101-6.
  26. Liu YT, Gao CM (2011). Physiological, reproductive factors and breast cancer risk in Jiangsu province of China. APJCP, 12, 787-90.
  27. Loh FH, Khin LW, et al (2005). The age of menopause and the menopause transition in a multiracial population: a nationwide Singapore study. Maturitas, 52, 169-80. https://doi.org/10.1016/j.maturitas.2004.11.004
  28. McDowell MA, Brody DJ, et al (2007). Has age at menarche changed? Results from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. J Adolescent Health, 40, 227-31. https://doi.org/10.1016/j.jadohealth.2006.10.002
  29. Menvielle G, Kunst AE, et al (2011). The contribution of risk factors to the higher incidence of invasive and in situ breast cancers in women with higher levels of education in the European prospective investigation into cancer and nutrition. Am J Epidemiol, 173, 26-37. https://doi.org/10.1093/aje/kwq319
  30. Nagata C, Hu Yh, et al (1995). Effects of menstrual and reproductive factors on the risk of breast cancer: metaanalysis of the case-control studies in Japan. Jpn J Cancer Res, 86, 910-5. https://doi.org/10.1111/j.1349-7006.1995.tb03000.x
  31. Parker L. (2001). Breast feeding and cancer prevention. Eur J Cancer, 37, 155-8.
  32. R Development Core Team (2011). R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna, Austria.
  33. Renehan AG, Tyson M, t al (2008). Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet, 371, 569-78. https://doi.org/10.1016/S0140-6736(08)60269-X
  34. Rosenblatt KA, Gao DL, et al (2006). Induced abortions and the risk of all cancers combined and site-specific cancers in Shanghai. Cancer Causes Control, 17, 1275-80. https://doi.org/10.1007/s10552-006-0067-x
  35. Shi J, Zhang M, et al (2010). Body mass index and its change in adulthood and breast cancer risk in China. APJCP, 11, 1213-8.
  36. Shin A, Song YM, et al (2011). Menstrual factors and cancer risk among Korean women. Int J Epidemiol, 40, 1261-8. https://doi.org/10.1093/ije/dyr121
  37. Tao P, Hu YY, et al (2011). Risk factors of breast cancer in Asian women:a Meta-analysis. Chin J Epidemiol, 32, 164-9.
  38. Trichopoulos D, MacMahon B, et al (1972). Menopause and breast cancer risk. J Natl Cancer Inst, 48, 605-13.
  39. Virasakdi (2011). epicalc: Epidemiological calculator. R package version 2.13.1.3. Chongsuvivatwong.
  40. Ziegler RG, Faupel-Badger JM, et al (2010). A new approach to measuring estrogen exposure and metabolism in epidemiologic studies. J Steroid Biochem Mol Biol, 121, 538-45. https://doi.org/10.1016/j.jsbmb.2010.03.068

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