| Abstract: | 研究目的：
乳癌的發生率為女性好發癌症的第一位，國人的十大癌症死因為第四位。乳癌的危險因子極多，其中包含有乳癌家族史者、曾罹患婦癌病史者、有菸癮、酗酒者、未曾哺育者等等。而乳腺炎則多數發生在年輕，尤其處於哺乳期的女性。有研究指出反覆的發炎和癌症有相關。因此，本研究欲探討乳腺炎與乳癌的相關性。
研究方法及資料：
本研究以台灣全民健保資料庫為材料執行的回溯性世代研究，使用健保資料庫2010年一百萬人承保抽樣歸人檔 (LHID 2010) ，收集2010年1月1日至2012年12月31日期間，曾因乳腺炎而於門診就診兩次(或以上)或住院一次(或以上)且大於20歲的女性乳癌患者為研究對象。第一部份，根據研究期間內曾罹患乳腺炎與不曾罹患乳腺炎將研究族群分為兩組進行描述性統計分析，探討兩組病人在人口統計學、共病分布狀況之異同，我們也利用Kaplan-Meier survival analysis做存活分析。第二部份，使用多變量Cox proportional hazard model，以探討在曾罹患乳腺炎患者是否會增加罹患乳癌的風險。
研究結果：
經過篩選之後，2010年至2012年間，符合本研究篩選條件的病患共507575位，其中曾罹患乳腺炎的為1574人，不曾罹患乳腺炎的為500482人。第一部份的研究結果，在平均年齡(mean±SD)方面，曾罹患乳腺炎與不曾罹患乳腺炎組別之平均年齡分別為34.7 ± 9.3歲與34.8 ± 9.4歲；這兩組在人口統計學上與共病分布之狀況無顯著差異。第二部份研究結果，Kaplan-Meier curve顯示曾罹患乳腺炎的患者，隨著時間的增長，罹患乳癌的風險越高，按照log-rank test 的結果，p = 0.001認為這兩組病患的罹患乳癌的風險有統計學上的差異。
結論與建議：
曾罹患乳腺炎與不曾罹患乳腺炎組別之間的共病並無統計學上的意義。本研究結果顯示曾罹患乳腺炎之患者會有較高的風險罹患乳癌，但從研究結果並未發現增加風險的共病，因此後續的研究或許可以做更長的追蹤與更深入的探討。
Objective：
Breast cancer is the leading cancer in woman, and rank at the fourth place of the top ten cause of death among Taiwanese. There are many risk factors for breast cancer, including family history of breast cancer, history of gynecologic cancer, smoking, alcoholics, and no breast feeding history. Most of the mastitis occurs in young, especially among lactating women. Some studies have shown that repeated inflammation and cancer are related. Therefore, this study objective is to determine the relationship between mastitis and breast cancer.
Methods and Materials：
The data source was a retrospective longitudinal dataset compiled by the Longitudinal Health Insurance Database 2010 (LHID 2010) which was collected by the National Health Insurance program. The LHID 2010 contains registration data of 1,000,000 individuals, randomly sampled from registry file of 2010. Data from January 1, 2010 to December 31, 2012 were collected, which include cases of mastitis, with at least two outpatient visits and one hospital admission, and female patients who were older than 20 years old. For the first part of the study, cases of mastitis and non-mastitis were divided into two groups for descriptive statistical analysis in order to analyze demographic data and distribution of co-morbidity. For the second part of the study, the multivariate Cox proportional hazard model was used to investigate whether patients with mastitis would have an increased risk of developing breast cancer.
Results：
A total of 507,575 patients who met the screening criteria of this study was selected between year 2009 and 2013, after selection, which included 1574 people who had mastitis, and 500,482 who did not have mastitis. For the first part of the study, the mean age (mean ± SD) were 34.7 ± 9.3 years and 34.8 ± 9.4 years, respectively for mastitis and non-mastitis group. There was no significant difference between the two group in terms of demographic characteristics and the co-morbidity. For the second part of the study, the Kaplan-Meier curve showed that patients who had mastitis had a higher risk of developing breast cancer in his/her lifetime. There was a statistically significant difference in the risk of breast cancer in the groups of mastitis patients, according to the log-rank test, which has p value = 0.001.
Conclusion and Suggestion：
There was no statistical significance in the co-morbidities between mastitis and non-mastitis group. The results of this study show that patients who had mastitis might have a higher risk of developing breast cancer, but the results of the study did not find increased risk of breast cancer in mastitis patient with co-morbidities. This may lead to a further investigations involving large studies by using time interval analyses are required to verify the association of mastitis with breast cancer. |
