Influence of estrogen plus progestin on breast, cancer and mammography in healthy postmenopausal women - The Women's Health Initiative Randomized trial
Influence of estrogen plus progestin on breast, cancer and mammography in healthy postmenopausal women - The Women's Health Initiative Randomized trial
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DOI：
10.1001/jama.289.24.3243
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发表时间：
2003-06-25
影响因子：
120.7
通讯作者：
McTiernan, A
中科院分区：
文献类型：
--
作者：
Chlebowski, RT;Hendrix, SL;McTiernan, A
背景：当包括浸润性乳腺癌在内的整体健康风险超过益处时，妇女健康倡议联合雌激素和孕激素的试验提前停止。尚未解决的突出问题包括在使用激素的女性中观察到的乳腺癌的特征，以及激素对乳房摄影的影响是否会影响诊断。目的确定雌激素和孕激素的使用、乳腺癌特征和乳房X光检查建议之间的关系。设计、设置和参与者在综合乳腺癌风险评估后，从1993年到1998年，在40个临床中心，16608名年龄在50到79岁、子宫完整的绝经后妇女被随机分配接受联合马类雌激素(0.625 mg/d)和醋酸甲羟孕酮(2.5 mg/d)或安慰剂。结果在意向处理分析中，雌激素+孕激素增加了乳腺癌的总数(245例比185例；风险比[HR]，1.24；加权P
Context The Women's Health Initiative trial of combined estrogen plus progestin was stopped early when overall health risks, including invasive breast cancer, exceeded benefits. Outstanding issues not previously addressed include characteristics of breast cancers observed among women using hormones and whether diagnosis may be influenced by hormone effects on mammography.Objective To determine the relationship among estrogen plus progestin use, breast cancer characteristics, and mammography recommendations.Design, Setting, and Participants Following a comprehensive breast cancer risk assessment, 16608 postmenopausal women aged 50 to 79 years with an intact uterus were randomly assigned to receive combined conjugated equine estrogens (0.625 mg/d) plus medroxyprogesterone acetate (2.5 mg/d) or placebo from 1993 to 1998 at 40 clinical centers. Screening mammography and clinical breast examinations were performed at baseline and yearly thereafter.Main Outcome Measures Breast cancer number and characteristics, and frequency of abnormal mammograms by estrogen plus progestin exposure.Results In intent-to-treat analyses, estrogen plus progestin increased total (245 vs 185 cases; hazard ratio [HR], 1.24; weighted P