PURPOSE This study explores factors that are associated with the severity of breast cancer (BC) at diagnosis. METHODS Interviews were conducted among women (n = 3326) aged 20-79 diagnosed with BC between 2011 and 2013 in Queensland, Australia. High-severity cancers were defined as either Stage II-IV, Grade 3, or having negative hormone receptors at diagnosis. Logistic regression models were used to estimate odds ratios (ORs) of high severity BC for variables relating to screening, lifestyle, reproductive habits, family history, socioeconomic status, and area disadvantage. RESULTS Symptom-detected women had greater odds (OR 3.38, 2.86-4.00) of being diagnosed with high-severity cancer than screen-detected women. Women who did not have regular mammograms had greater odds (OR 1.78, 1.40-2.28) of being diagnosed with high-severity cancer than those who had mammograms biennially. This trend was significant in both screen-detected and symptom-detected women. Screen-detected women who were non-smokers (OR 1.77, 1.16-2.71), postmenopausal (OR 2.01, 1.42-2.84), or employed (OR 1.46, 1.15-1.85) had greater odds of being diagnosed with high-severity cancer than those who were current smokers, premenopausal, or unemployed. Symptom-detected women being overweight (OR 1.67, 1.31-2.14), postmenopausal (OR 2.01, 1.43-2.82), had hormone replacement therapy (HRT) < 2 years (OR 1.60, 1.02-2.51) had greater odds of being diagnosed with high-severity cancer than those of healthy weight, premenopausal, had HRT > 10 years. CONCLUSION Screen-detected women and women who had mammograms biennially had lower odds of being diagnosed with high-severity breast cancer, which highlighted the benefit of regular breast cancer screening. Women in subgroups who are more likely to have more severe cancers should be particularly encouraged to participate in regular mammography screening.

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与被诊断出患有严重乳腺癌的相关因素：澳大利亚昆士兰的一项基于人群的研究。

目的 本研究探讨与诊断时乳腺癌 (BC) 严重程度相关的因素。方法 对 2011 年至 2013 年间在澳大利亚昆士兰州诊断为 BC 的 20-79 岁女性（n = 3326）进行了访谈。高严重性癌症被定义为 II-IV 期、3 级或在诊断时具有阴性激素受体。Logistic 回归模型用于估计与筛查、生活方式、生殖习惯、家族史、社会经济地位和地区劣势相关的变量的高严重度 BC 的优势比 (OR)。结果 与筛查检测到的女性相比，症状检测到的女性被诊断出患有高严重性癌症的几率更高（OR 3.38，2.86-4.00）。没有定期进行乳房 X 光检查的女性的几率更大（OR 1.78, 1.40-2. 28) 被诊断出患有高严重性癌症的人数比每两年进行一次乳房 X 光检查的人高。这种趋势在屏幕检测和症状检测的女性中都很显着。与非吸烟者 (OR 1.77, 1.16-2.71)、绝经后 (OR 2.01, 1.42-2.84) 或受雇女性 (OR 1.46, 1.15-1.85) 相比，筛查检测出的女性被诊断出患有高危癌症的几率更高目前吸烟者、绝经前或失业者。症状检测到的超重 (OR 1.67, 1.31-2.14)、绝经后 (OR 2.01, 1.43-2.82)、激素替代治疗 (HRT) < 2 年 (OR 1.60, 1.02-2.51) 的女性被诊断出患有癌症的严重程度高于健康体重者，绝经前，HRT>10 年。结论 筛查检测到的女性和每两年进行一次乳房 X 光检查的女性被诊断为高严重性乳腺癌的几率较低，这突出了定期进行乳腺癌筛查的好处。应特别鼓励更可能患更严重癌症的亚组女性参加定期乳房 X 光检查。