유방조직의 에스트로겐 수용체 발현에 따른 유방암 발생예측과 예방에 관한 연구

초록

Purpose: Estrogen receptor (ER) expression is known to be one of the major risk factors for breast cancer, and increased estrogen responsiveness of the breast epithelium may enhance this effect. We examined the relationship between breast cancers and benign breast diseases using ER-positive or ER-negative expression status and other established or potential risk factors. Methods: ER expression was measured by immunohistochemistry in 33 breast tissues from benign breast diseases and 208 breast cancer tissues. Data on established or possible risk factors—including age, age at menarche, age at first delivery, feeding methods, family history of breast cancer, menopausal status, hormonal replacement therapy, and use of oral contraceptive pills—were collected prior to surgery. Multiple logistic regression analyses were used to assess breast cancer risk (odds ratios [ORs]) associated with ER-positive expression. Results: The rate of ER positivity was significantly higher in malignant breast tissues than in benign breast tissues, and ER positivity was associated with an increased risk of breast cancer (p < 0.01). The crude OR for breast cancer in ER-positive versus ER-negative tissues was 3.38 (95% confidence interval [CI], 1.32–9.24). After adjusting for all factors, ORs for breast cancer were above 4.0 for several risk factors, including older age at operation, postmenopausal status, age over 30 at first delivery, absence of breastfeeding, and a family history of breast cancer, with the exception of age at menarche. Conclusion: For early detection and prevention of breast cancer, careful follow-up is recommended for patients with benign breast disease who have ER-positive expression—particularly those who are postmenopausal, had their first delivery after age 30, did not breastfeed, or have a family history of breast cancer. ER positivity in benign breast epithelium may increase estrogen sensitivity and consequently elevate the risk of breast cancer.

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