2022年 · 第16卷第02期

The vast majority of breast tumors are cancerous caused by breast epithelial cells, and breast sarcomas, which are thought to originate from the interstitial components of the breast, are rare. The greater the breast density measured by mammography, i.e., the higher the proportion of breast fibroglandular tissue (composed of epithelium and stroma), the higher the risk of breast cancer. Fertility-related reproductive factors are also considered to be risk factors for breast cancer, such as parity, age at first birth and breastfeeding. To investigate the relationship between reproductive factors related to fertility and breast gland tissue composition, the researchers used women with biopsy-confirmed benign breast disease (BBD) in the American Nurses Health Study cohort to conduct the study. All study subject biopsy specimens were obtained, and each tissue type (epithelial, interstitial, and adipose) percentage was measured on full-slice images using deep learning techniques. A total of 983 carcinoma-free women with BBD confirmed by biopsy were included in the study. The age range of biopsy was 19 to 58 years old, and the mean age of biopsy was 42 years old. The proportions of epithelial tissue, interstitial tissue and adipose tissue ranged from 0.5% to 52.2% (mean 9.1%), 23.6% to 99.0% (mean 72.4%) and 0 to 71.3% (mean 18.5%), respectively. Results of multivariate-adjusted generalized linear regression analysis showed that compared with women who had given birth, epithelial tissue in benign breast biopsy specimens of non-fertile women (Beta=-0.26，95%CI: -0.41 to-0.11) and adipose tissue (Beta=-0.34，95%CI: -0.54~ -0.13) was less proportional, while the proportion of interstitial tissue was more (Beta=0.04，95%CI: 0.01~0.08), especially among premenopausal women, the difference in the proportion of tissue distribution was more obvious. In women who had given birth, parity of births was inversely correlated with the proportion of interstitial tissue (per childBeta=-0.01，95%CI：-0.02~-0.00）； And primiparous age<The proportion of epithelial tissue in benign breast biopsy specimens from women aged 25 to 29 years with primiparous age was higher than that of 25 years old (Beta=0.12，95%CI：0.03~0.21）。 Breastfeeding duration ≥24 months was associated with reduced proportion of adipose tissue in benign breast biopsy specimens compared to breastfeeding duration 0 to 1 month (Beta=-0.30，95%CI：-0.54~-0.06；P_Trendiness=0.04）。 In premenopausal women, more parity and late primiparous age were associated with a higher proportion of epithelial tissue and a lower proportion of interstitial tissue. The findings also suggest the importance of epithelial-mesenchymal interactions.