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Initiators and prom...
Initiators and promoters for the occurrence of screen-detected breast cancer and the progression to clinically-detected interval breast cancer
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Yen, Amy Ming-Fang (författare)
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- Wu, Wendy Yi-Ying (författare)
- Umeå universitet,Institutionen för strålningsvetenskaper,Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Tabar, Laszlo (författare)
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Duffy, Stephen W. (författare)
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Smith, Robert A. (författare)
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Chen, Hsiu-Hsi (författare)
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(creator_code:org_t)
- ELSEVIER SCIENCE INC, 2017
- 2017
- Engelska.
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Ingår i: Journal of Epidemiology. - : ELSEVIER SCIENCE INC. - 0917-5040 .- 1349-9092. ; 27:3, s. 98-106
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: The risk factors responsible for breast cancer have been well documented, but the roles of risk factors as initiators, causing the occurrence of screen-detected breast cancer, or promoters, responsible for the progression of the screen-detected to the clinically-detected breast cancer, have been scarcely evaluated.Methods: We used data from women in a cohort in Kopparberg (Dalarna), Sweden between 1977 and 2010. Conventional risk factors, breast density, and tumor-specific biomarkers are superimposed to the temporal course of the natural history of the disease.Results: The results show that older age at first full-term pregnancy, dense breast, and a family history of breast cancer increased the risk of entering the preclinical screen-detectable phase of breast cancer by 23%, 41%, and 89%, respectively. Overweight/obesity (body mass index >= 25 kg/m(2)) was a significant initiator (adjusted relative risk [aRR] 1.15; 95% confidence interval [CI], 0.99-1.33), but was inversely associated with the role of promoter (aRR 0.65; 95% CI, 0.51-0.82). Dense breast (aRR 1.46; 95% CI, 1.12 -1.91), triple-negative (aRR 2.07; 95% CI, 1.37-3.15), and Ki-67 positivity (aRR 1.66; 95% CI, 1.19-2.30) were statistically significant promoters. When the molecular biomarkers were considered collectively as one classification, the basal-like subtype was the most influential subtype on promoters (aRR 4.24; 95% CI, 2.56-7.02) compared with the Luminal A subtype.Discussion: We ascertained state-dependent covariates of initiators and promoters to classify the risk of the two-step progression of breast cancer. The results of the current study are useful for individually-tailored screening and personalized clinical surveillance of patients with breast cancer that was detected at an early stage.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Breast cancer
- Risk factor
- Personalized
- Multi-state
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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