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    • terbinafine hydrochloride Characteristics of breast cancer p

    2018-11-14

    Characteristics of breast cancer patients and healthy controls together with crude ORs from univariable analyses are shown in Table 1. As expected positive family history of breast cancer was the most pronounced risk factor. Further characteristics that were significantly different between cases and controls were a family history of other cancers such as prostate, ovarian and endometrium cancer, history of benign breast disease and a lower body mass index. As shown in Table 2, self-reported use of UCP at early ages (<30years) was significantly associated with an increased risk of breast cancer (p=0.0358) adjusting for age, family history of breast cancer, family history of other cancer, history of benign breast disease, age at menarche, parity, age at birth of first child, age at menopause, menopausal status, hormone replacement therapy, average body mass index and alcohol consumption. This association was triggered by women who reported that they had used UCPs several times per day under their age of 30 increasing their risk for breast cancer by an OR of 3.88 with a 95% CI of 1.03–14.66 (p=0.0456). Aluminum in breast tissue (Table 3) was found in both cases and controls ranging from to 367.38nmol/g dry weight and was significantly associated with self-reported UCP use (p=0.0344 for UCP use under the age of 30, p=0.0093 for UCP use during the last 5years). In cases, median (interquartile) aluminum concentrations observed were 5.8 (2.3–12.9) nmol/g, significantly higher (p=0.0014) than in controls (3.8, 2.5–5.8nmol/g). In addition, we analyzed whether tumor localization modifies the relationship between self-reported UCP use, aluminum concentration and the risk for BC. Regarding UCP use there was no significant effect modification by tumor localization (p=0.680 for the UCP use <30years, p=0.341 for the UCP use during last 5years). In contrast, regarding measured aluminum concentrations, the stratified results for tumor localization showed significant differences between cases and controls in the subgroup of cases with a tumor in the upper outer quadrant only (Table 4).
    Discussion In terbinafine hydrochloride to our findings, previous epidemiologic studies (Fakri, 2006; Mirick et al., 2002) did not support the hypothesis that UCP use increases the risk for breast cancer. Fakri (2006) examined a very small sample of 54 unmatched cases and 50 controls underpowered to detect realistic effect sizes. In their terbinafine hydrochloride study UCP use was dichotomous categorized in just two levels, using of UCPs versus no use, which is too imprecise in regard to our results, where a significant association was observed only when women used UCPs several times per day. Similarly, in the much larger study of Mirick et al. (2002), UCP use was measured also in a dichotomous way only. In the study of Mirick et al. (2002) study participants were not asked about UCP use in different life time categories and therefore possible effects of UCP use at younger ages were not detectable. In fact, Mirick et al. (2002) reported antiperspirant use rather than UCP use, however, in the light of our experiences it is unclear how the authors discriminated between deodorant and antiperspirant use. Another important difference between Mirick et al. (2002) and our study exists regarding the birth cohorts of breast cancer patients recruited into the two studies. Breast cancer patients participating in the study of Mirick et al. (2002) were diagnosed in the early 1990′s, on average 20years earlier than patients in our study. At the time relevant for exposure, approximately between 1940 and 1960, the use of UCPs was less common than 20years later. UCP use strongly increased in the last four decades and also cultural habits such as shaving of axilla hair became only popular during the late 1980′s in western countries (Darbre, 2009, 2003; McGrath, 2003). So far, there exist six studies that measured aluminum concentration in breast cancer patients comparing concentrations between benign and malign breast tissues (Exley et al., 2007; House et al., 2013; Millos et al., 2009; Ng et al., 1997; Pasha et al., 2008; Rodrigues-Peres et al., 2013). These studies differed considerably regarding the amount of aluminum found in breast tissue likely because of discrepancies in measurement techniques. Regarding, the analytical approach the measured aluminum concentrations in our cohort were similar to the studies of House et al. (2013) and Rodrigues-Peres et al. (2013).