Relationship of women’s breast nodules with lifestyle, mental health and metabolic characteristics: a large, retrospective, longitudinal cohort study

BACKGROUND: Previous studies specific to breast nodules are relatively scarce and mainly rely on cross-sectional research methods, overlooking the dynamic evolution of breast nodules over time. Thus, the objective is to analyze the impact of lifestyle, mental health, and metabolic characteristics on the occurrence and progression of breast nodules by conducting a longitudinal study. METHODS: This retrospective, longitudinal cohort study conducted from 2012 to 2021 included 114,774 measurements from the Health Management Center at the Third Xiangya Hospital of Central South University in China. All data were collected from the results of anthropometric measurements, laboratory tests, breast ultrasound and online questionnaire surveys. Generalized estimating equations (GEE) models were developed to examine the relationship. RESULTS: Women who always ate punctual meals or consumed soy products ≥ 5 times per week had lower odds of breast nodule occurrence (adjusted odds ratio [aOR] 0.798, 95% CI 0.761-0.836, p < 0.001; aOR 0.791, 95% CI 0.689-0.908, p = 0.001). In contrast, women who had socializing meals of ≥ 3 times per week had higher odds of breast nodule occurrence (aOR 1.315, 95% CI 1.124-1.538, p = 0.001). Higher serum creatinine and lower serum uric acid were also associated with increased risk of breast nodule occurrence (aOR 1.001, 95% CI 1.000-1.001, p = 0.012; aOR 0.999, 95% CI 0.999-1.000, p < 0.001). Women with fair sleep quality had higher breast nodule occurrence (aOR 1.074, 95% CI 1.027-1.122, p = 0.002) but a lower risk of progression to BI-RADS ≥ 4 A (aOR 0.760, 95% CI 0.607-0.952, p = 0.017). CONCLUSIONS: Our study revealed significant correlations between breast nodules and various lifestyle factors and metabolic characteristics, but the correlations between breast nodules and mental health were not found. These findings may provide insights into potential factors related to breast nodules and guide future research on their prevention and management.