摘要：Objectives. To review the contribution of the Nurses’ Heath Study (NHS) and the NHS II in identifying risk and protective factors for breast cancer incidence and survival. Methods. We conducted a narrative review of NHS and NHS II articles on breast cancer incidence and survival published from 1976 to 2016, with a focus on exogenous and endogenous hormones; lifestyle factors, including diet, physical activity, and aspirin use; intermediate markers of risk; and genetic factors. Results. With the investigation of individual risk factors, as well as their incorporation into risk prediction models, the NHS has contributed to the identification of ways in which women may reduce breast cancer risk, including limiting alcohol consumption, reducing the duration of postmenopausal estrogen-plus-progestin use, avoiding weight gain, and increasing vegetable consumption. In addition, the NHS has helped elucidate the roles of several biomarkers and contributed to the identification of risk alleles. Conclusions. The NHS has contributed to our understanding of lifestyle, hormonal, and genetic risk factors for breast cancer, highlighting the importance of exposures across the life course, and has helped identify lifestyle changes that may reduce risk and improve survival after a diagnosis of breast cancer. The Nurses’ Health Study (NHS) originated with the goal of examining use of oral contraceptives and other potential risk factors for breast cancer. Beginning with our first breast cancer publication on use of permanent hair dyes in 1979, we have investigated a wide range of lifestyle factors, medications, and biomarkers, as well as intermediate endpoints and tumor characteristics. Highlights of our findings related to breast cancer, their contributions to public health, and future research directions are described in this article.
