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What causes breast cancer? Risk What causes breast cancer? by 刘丹丹 Risk

Age-standardised death rates pidemiology Age-standardised death rates from Breast cancer by country (per 100,000 inhabitants)1 Risk

CONTENTS Heredity Age Others Hormones Dietary factors Risk of factors 1 2 Age Risk of factors Others Hormones 3 4 5 Risk Dietary factors

1 2 3 4 5 Risk [1] Risk of factor Age Risk

Age Probability of breast cancer increases with age. Breast cancer incidence by age in women in the United Kingdom 2006-2008.2

1 2 3 4 5 Risk [2] Risk of factor Heredity Risk

Heredity Risk One pedigree of breast cancer3 Note that the proband (indicated by the arrow) had breast cancer at age 38. We see that her mother (III-1) had breast cancer at age 30, her grandmother (II-1) had ovarian cancer at age 58, and her great-grandmother (I-2) had breast cancer at age 39. Thus, we see four generations affected with breast or ovarian cancer. One pedigree of breast cancer3

Predisposing genes Predisposing genes Mutation BRCA2 BRCA1 BRCA1(breast cancer 1)4、 BRCA2、P53 、Her-2/neu 中间那个图点一下就出来然后再点一下出来左右两个图，左边那个写上：BRCA1、右边那个写上BRCA2. Women who carry a harmful BRCA mutation have a 60% to 80% risk of developing breast cancer in their lifetimes.首先是出现字，然后是中间那个图出现一会，点一下消失，然后左边那个是BRCA1 ，右边这个图是BRCA2。其中，点击字的时候就出来这个图。。再点一下这个图，就显示红色线条处弹出一个字（Mutation)..意思就是：代表那个位置发生突变咯。。antioncogene:抑癌基因 In 5% of breast cancer cases, there is a strong inherited familial risk

1 2 3 4 5 Risk [3] Risk of factor Hormones Risk

Hormones Estrogen Risk Mammary epithelial cells normal cells estrogen 图片顺序是：第一个直接出现的，然后顺着箭头是上面的那个名字和图，它后面的名字和图；然后是下面那个路径，因为最后一个是很多细胞，希望可以有一点点时差的一起出现。体现增殖的过程 多情况下，增加暴露于内源性雌激素，包括不生孩子，推迟首次生育，不哺乳，早初潮（第一次月经周期）和晚期绝经怀疑的一生中患乳腺癌的风险增加。 stem cells cancer cells

circumstances increasing exposure to endogenous estrogens5 Risk Not breastfeeding Not having children Early menarche Late menopause Delaying first childbirth

1 2 3 4 5 Risk [4] Risk of factor Risk Dietary factors

Dietary factors Alcohol Iodine Vitamin D deficiency Calcium Fat-intake 1 3 4 5 Risk 6 2 Calcium Fat-intake Phytoestrogens

Risk and fat intake Comparison of age-standardized death rates of breast cancer with fat intake, from national food-consumption data for various countries in 20046 用个圈圈出The netherlands..最上面的点。。 Risk

subtypes of breast cancer Fat intake and risk of subtypes of breast cancer Multivariable relative risk (RR) of subtypes of breast cancer according to cumulative averaged fat intake in women aged 26–46 years at baseline enrolled in the Nurses’Health Study 7 点一下，左边纵裂的英文名词全部画下划线然后，再点一下TOTAL的那个横排的后两个数字一起画圈。（也就是先纵向比较再横向比较） 不同类型脂肪导致不同亚型的乳腺癌的危险度不同。 One recent study suggests that low-fat diets may significantly decrease the risk of breast cancer as well as the recurrence of breast cancer

Fat contributes to breast cancer Right? Risk

Fat intake breast cancer PHOTO Relative risks and 95 percent confidence intervals for various levels of energy from fat8 Risk

Dietary influences Risk have been examined since decades with conflicting results and so far failed to confirm any significant dependency9. 这张是有字的 Risk

1 2 3 4 5 Risk [5] Risk of factor Others Risk

Folic acid (folate) Abortion Bras Others Deodorants Fertility treatments Others Abortion Viruses Deodorants Bras

Risk http://www.cancer.gov 1 2 3 4 5

Reference 4.Malone KE, Daling JR, Thompson JD, O'Brien CA, Francisco LV, Ostrander EA (1998). "BRCA1 mutations and breast cancer in the general population: analyses in women before age 35 years and in women before age 45 years with first-degree family history". JAMA 279 (12): 922–9. 1.Vector map from BlankMap-World6, compact.svg by Canuckguy et al.Data from Death and DALY estimates for 2004 by cause for WHO Member States (Persons, all ages) (2009-11-12) 7.David,J. cohort studies of fat in take and the risk of breast cancer-a pooled analysis。the new England journal of medicine.356-360. 8.Chlebowski RT, Blackburn GL, Thomson CA, Nixon DW, Shapiro A, Hoy MK, et al. (2006). "Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study (WINS)". J Natl Cancer Inst 98 (24) Risk 2.Breast Cancer (C50), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2006-2008 at Breast cancer - UK incidence statistics at Cancer Research UK. Section updated 18/07/11. 5. Collaborative Group on Hormonal Factors in Breast Cancer (1996). "Breast cancer and hormonal contraceptives: further results". 6.Diet and cancer — the European Prospective Investigation into Cancer and Nutrition.Sheila Bingham & Elio Riboli.Nature Reviews Cancer 4, 206-215 (March 2004) doi:10.1038/nrc1298 9.Hunter DJ, Spiegelman D, Adami HO, et al. (1996). "Cohort studies of fat intake and the risk of breast cancer--a pooled analysis". N. Engl. J. Med. 334 (6): 356–61. 3.Http://medschool.creighton.edu/medicine/centers/erdn/educational/pedigree/index.php

1 2 What causes breast cancer? Thank you! Risk 3 4 5 Risk