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Psychosocial stress is associated with benign breast disease in young Chinese women: results from Project ELEFANT

Abstract

Purpose

Psychosocial stress, including bereavement and work-related stress, is associated with the risk of breast cancer. However, it is unknown whether it may also be linked with increased risk of benign breast disease (BBD).

Methods

Our study leveraged 61,907 women aged 17–55 years old from the Project ELEFANT study. BBD was diagnosed by clinician. Self-reported data on psychosocial stress over a 10-year period was retrospectively collected from questionnaires and categorised by cause (work, social and economic) and severity (none, low and high). Odd ratios (ORs) for the development of BBD were estimated using logistic regression. The model was adjusted for age, BMI, TSH levels, smoking, alcohol consumption, family history, age of menarche, oral contraceptive usage, education and occupation.

Results

Within our study, 8% (4,914) of participants were diagnosed with BBD. Work-related stress [OR 1.57, 95% confidence interval (CI) 1.46–1.69] and financial stress (OR 1.34, 95% CI 1.24–1.44) were significantly associated with BBD incidence, with a smaller but still significant association with social stress (OR 1.11, 95% CI 1.01–1.21). The associations remained significant after exclusion of participants with first- and second-degree family history of breast disease. The presence of multiple forms of stress did not synergistically increase risk. The neutrophil–lymphocyte ratio (NLR), a marker of systemic inflammation and prognostic marker for breast cancer, was not associated with BBD.

Conclusions

Psychosocial stress, particularly work-related and financial stress, is associated with increased risk of benign breast disease among young Chinese women.

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Abbreviations

BBD:

Benign breast disease

BMI:

Body Mass Index

NLR:

Neutrophil–lymphocyte ratio

OR:

Odds ratio

SD:

Standard deviation

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Acknowledgements

We are extremely grateful to the Tianjin Research Institute for Family Planning which provided the data and samples for the study.

Funding

This work was supported by the National Natural Science of China, Foundation of China Youth Science Fund Projects (Grant Numbers: 81602827 for LG and 41601548 for PL), and by the Tianjin Natural Science Foundation (Grant Number: 18JCQNJC11700 for LG).

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Correspondence to Liqiong Guo.

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All the authors declare that they have no conflicts of interest.

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All procedures and study protocols were approved by the ethical committee of Tianjin Medical University and were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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All the participants within the study provided written informed consent.

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Barrow, T.M., Peng, C., Wilson, A. et al. Psychosocial stress is associated with benign breast disease in young Chinese women: results from Project ELEFANT. Breast Cancer Res Treat 173, 217–224 (2019). https://doi.org/10.1007/s10549-018-4979-4

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  • DOI: https://doi.org/10.1007/s10549-018-4979-4

Keywords

  • Benign breast disease
  • Stress
  • Psychosocial stress
  • Neutrophil–lymphocyte ratio