Premenopozal Meme Kanserli Kadınlarda Bazı Risk Etmenlerinin İncelenmesi: Vaka-Kontrol Çalışması

Amaç: Bu çalışma premenapozal kadınlarda bazı meme kanseri risk etmenlerinin araştırılması amacıyla planlanmıştır. Bireyler ve Yöntem: Kasım 2013-Temmuz 2014 tarihleri arasında Hacettepe Üniversitesi Onkoloji Hastanesi'ne başvuran, premenopozal, meme kanseri tanısını yeni almış, opere olmuş veya olmamış, 25-50 yaş aralığında, 70 kadın birey ile yaş, cinsiyet ve menopozal durumları eşleştirilmiş, eşit sayıda yetişkin sağlıklı kadın birey ile yürütülmüştür. Bulgular: İlk doğumunu 20 yaşından önce yapan bireylerin, 30 yaşından sonra doğum yapanlara göre hastalık riskinin %81 oranında daha düşük olduğu saptanmıştır. Benzer şekilde ilk doğum yaşındaki her bir birimlik azalmanın meme kanseri riskini yaklaşık olarak %8 oranında azalttığı da belirlenmiştir. Emzirme durumunun meme kanseri riski ile ilişkili olduğu ve emzirmeyen bireylerin, emziren bireylerle karşılaştırıldığında istatistiksel olarak anlamlı şekilde 2.2 kat meme kanseri risklerinin daha yüksek olduğu görülmüştür. Çalışmaya katılan bireylerin kümülatif sigara içiciliği incelendiğinde, hasta grubunun, kontrol grubuna göre daha yüksek tüketim gösterdiği saptanmıştır. Sonuç: Değiştirebilir risk etmenleri göz önünde bulundurularak, risk gruplarının belirlenmesi ile meme kanseri insidansında azalma sağlayan önleme stratejilerine katkı sağlanabilir.

Evaluation of Some Risk Factors on Premenopausal Breast Cancer Women: A Case-Control Study

Aim: This study was carried out to determine some risk factors of breast cancer in premenopausal women. Subjects and Methods: This study was conducted on 70 premenopausal female individuals with newly diagnosed breast cancer who had been operated or not and applied to Hacettepe University Oncology Hospital between November 2013-July 2014, and on equal number of healthy adult female individuals who were paired in order to ensure the standardization in age, gender and menopausal status. Results: When individuals who have their first child before the age of 20 were compared with the individuals who have their first child after the age of 30, their breast cancer risk was determined to be lower by 81%. Similarly breast cancer risk is decreased 8% for each first birth unit. There is an association between breast-feeding and breast cancer risk and women who had breastfed and not were compared, their breast cancer risk was determined to be 2.2 times higher and statistically significant difference was determined. When the cumulative smoking status of the individuals participating in this study is examined the patient group showed higher smoking rate than the control group. Conclusion: By taking into consideration of modifiable factors and identification of risk groups may contribute to the development of prevention strategies in decreasing breast cancer incidence.

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1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA: Cancer J Clin 2015;65(2):87-108.
2. Ronco AL, De Stéfani E. Nutritional epidemiology of breast cancer. Springer Science & Business Media, London, 2011.
3. Tarver T. Cancer Facts & Figures 2012. American Cancer Society (ACS) Atlanta, GA: American Cancer Society 2012;66.
4. http://kanser.gov.tr/daire-faaliyetleri/kanseristatistikleri/1445-t%C3%BCrkiye-kanser-istatistiklerirapor-k%C4%B1sa.html. Accessed September 10, 2016.
5. Brawer R, Brisbon N, Plumb J. Obesity and cancer. Primary Care: Clinics in Office Practice 2009;36(3):509- 531.
6. Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 1981;66(6):1192-1308.
7. WHO. International guide for monitoring alcohol consumption and related harm. 2000.
8. Cui Y, Miller AB, Rohan TE. Cigarette smoking and breast cancer risk: update of a prospective cohort study. Breast Cancer Res Treat 2006;100(3):293-299.
9. Statistical Packages for Social Sciences Programme (SPSS version 15.0, C., USA).
10. Altekruse S, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER cancer statistics review, 1975-2007. Bethesda, MD: National Cancer Institute, 2010;7.
11. DeSantis C, Siegel R, Bandi P, Jemal A. Breast cancer statistics, 2011. CA: Cancer J Clin 2011;61(6):408-418.
12. Howlander N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF. SEER Cancer Statistics Review 1975-2012.
13. http://kanser.gov.tr/daire-faaliyetleri/kanseristatistikleri/1793-2013-%C4%B1l%C4%B1- t%C3%BCrkiye-kanser-istatistikleri.html. 2013. Accessed September 10, 2016
14. Brinton LA, Schairer C, Hoover RN, Fraumeni JF. Menstrual factors and risk of breast cancer. Cancer Invest 1988;6(3):245-254.
15. Key T, Appleby P, Barnes I, Reeves G. Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst 2002;94(8):606-616.
16. Ban KA, Godellas CV. Epidemiology of breast cancer. Surg Oncol Clin N Am 2014;23(3):409-422.
17. Hiatt RA, Porco TC, Liu F, Balke K, Balmain A, Barlow J et al. A multilevel model of postmenopausal breast cancer incidence. Cancer Epidemiol Biomarkers Prev 2014;23(10):2078-2092.
18. https://nccih.nih.gov/health/integrative-health. Accessed September 14, 2016.
19. Islami F, Liu Y, Jemal A, Zhou J, Weiderpass E, Colditz G et al. Breastfeeding and breast cancer risk by receptor status--a systematic review and meta-analysis. Ann Oncol 2015;26(12):2398-2407.
20. Manrique TJ, Figuerol CM, Cuéllar DFA. Breastfeeding as a method of breast cancer prevention. Rev Enferm 2015;38(12):32-38.
21. Yang L, Jacobsen KH. A systematic review of the association between breastfeeding and breast cancer. J Womens Health 2008;17(10):1635-1645.
22. Kaminska, M, Ciszewski T, Szatan K, Miotta P, Staroslawka E. Breast cancer risk factors. Prz Menopauzalny 2015;14(3):196-202.
23. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50 302 women with breast cancer and 96 973 women without the disease. The Lancet 2002;360(9328):187-195.
24. Collaborative G. Breast cancer and hormonal contraceptives: further results. Collaborative Group on Hormonal Factors in Breast Cancer. Contraception 1996;54:1S-106S.
25. Pike M, Krailo MD, Henderson A, Roy DS. Breast cancer in young women and use of oral contraceptives: possible modifying effect of formulation and age at use. The Lancet 1983;322(8356):926-929.
26. Casey PM, Cerhan JR, Pruthi S. Oral contraceptive use and the risk of breast cancer. Mayo Clin Proc 2008. Elsevier.
27. Westhoff CL. Breast cancer risk: perception versus reality. Contraception 1999;59(1):25-28.
28. Tamimi RM, Hankinson SE, Chen WY. Combined estrogen and testosterone use and risk of breast cancer in postmenopausal women. Arch Intern Med 2006;166(14):483-1489.
29. Pharoah PD, Day NE, Duffy S, Easton D, Ponder BAJ. Family history and the risk of breast cancer: A systematic review and meta-analysis. Int J Cancer 1997;71(5):800-809.
30. Frank TS, Manley SA, Olopade OI, Cummings S, Garber JE, Bernhardt B, et al. Sequence analysis of BRCA1 and BRCA2: correlation of mutations with family history and ovarian cancer risk. J Clin Oncol 1998;16(7):2417-2425.
31. McPherson K, Steel C, Dixon J. Breast cancer-- epidemiology, risk factors, and genetics. BMJ 2000;321(7261):624-628.
32. General S. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General. Reports of the Surgeon General. Atlanta (GA), 2014.
33. Macacu A, Autier P, Boniol M, Boyle P. Active and passive smoking and risk of breast cancer: a metaanalysis. Breast Cancer Res Treat 2015;154(2):213- 224.
34. Reynolds P. Smoking and breast cancer. J Mammary Gland Biol Neoplasia 2013;18(1):15-23.
35. Health, U.D.o. and H. Services, The health consequences of smoking: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004. 62.
36. Cox DG, Dostal L, Hunter DJ, Marchand LL, Hoover R, Zeigler RG. N-acetyltransferase 2 polymorphisms, tobacco smoking, and breast cancer risk in the breast and prostate cancer cohort consortium. Am J Epidemiol 2011:kwr257.
37. Kungu A, Hamajima N, Hirose K. Alcohol, tobacco and breast cancer--collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer 2002;87(11):1234-1245.
38. Smith-Warner SA, Spiegelman D, Yaun SS, Brandt PA, Folsom AR, Goldbohm RA, et al. Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA 1998;279(7):535-540.
39. Ronco AL, De Stéfani E. Nutritional Epidemiology of Breast Cancer. Springer Science & Business Media, London, 2012.
40. Tjønneland A, Christensen J, Olsen A, Stripp C, Thomsen BL, Overvad K, et al. Alcohol intake and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control 2007;18(4):361-373.