Factors modifying the association between hormone-replacement therapy and breast cancer risk
Factors modifying the association between hormone-replacement therapy and breast cancer risk
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DOI：
10.1007/s10654-005-0032-0
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发表时间：
2005-08-01
影响因子：
13.6
通讯作者：
Brüning, T
中科院分区：
文献类型：
--
作者：
Pesch, B;Ko, Y;Brüning, T
目的：激素替代疗法（HRT）是乳腺癌的既定危险因素。 HRT 用户在社会经济和其他特征方面不同于非用户。有些女性的激素替代疗法相关风险可能会受到其他因素的调节。方法：我们对 688 例乳腺癌病例和 724 例对照进行了一项基于人群的病例对照研究，以描述 HRT 用户的特征，并估计 HRT 使用的比值比 (OR) 和 95% 置信区间 (CI) 以及潜在的风险调整因素。结果：在 50 岁及以上的女性中，58% 的对照者和 61% 的病例曾经使用过 HRT。在自然绝经的女性中，使用 HRT 10 年及以上与乳腺癌风险增加相关（OR 1.79，95% CI，1.12-2.87），但在手术绝经的女性中则不然（OR 0.61，95% CI，0.09-4.17）。在有乳腺癌阳性家族史的女性亚组中，每年使用 HRT 会使风险增加 1.22（95% CI，1.02-1.47）。另一个亚组包括至少进行过 10 次诊断性乳房 X 光检查的女性（使用 HRT 10 年或以上的 OR 4.04，95% CI，1.10-14.81）。结论：长期使用激素替代疗法与自然绝经女性的乳腺癌风险相关。我们的研究结果表明，对于有乳腺癌阳性家族史的女性以及经常接受乳房X线检查筛查的女性，这种风险可能会增加。
Objectives: Hormone-replacement therapy (HRT) is an established risk factor for breast cancer. HRT users are different from non-users with respect to socio-economic and other characteristics. There may be women where the HRT-related risk could be modulated by other factors. Methods: We conducted a population-based case-control study with 688 breast cancer cases and 724 controls to characterize HRT users and to estimate odds ratios (OR) and 95% confidence intervals (CI) for HRT use and potentially risk modifying factors. Results: In women aged 50 years and older, 58% of controls and 61% of cases ever used HRT. Among women in natural menopause, HRT use for 10 years and more years was associated with an increased breast cancer risk (OR 1.79, 95% CI, 1.12-2.87), but not among women in surgical menopause (OR 0.61, 95% CI, 0.09-4.17). In the subgroup of women with a positive family history of breast cancer, each year of HRT use increased the risk by 1.22 (95% CI, 1.02-1.47). Another subgroup comprised women with at least 10 diagnostic mammograms (OR 4.04, 95% CI, 1.10-14.81 for using HRT 10 or more years). Conclusions: Long-term HRT use was associated with a breast cancer risk in women with natural menopause. Our findings suggest that this risk may be increased in women with a positive family history of breast cancer and in women who received frequent diagnostic mammographic screens.