Use of menopausal hormone therapy and risk of ductal and lobular breast cancer among women 55-74 years of age.
Use of menopausal hormone therapy and risk of ductal and lobular breast cancer among women 55-74 years of age.
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DOI：
10.1007/s10549-014-2960-4
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发表时间：
2014-06
影响因子：
3.8
通讯作者：
Malone, Kathleen E.
中科院分区：
文献类型：
--
作者：
Li, Christopher I.;Daling, Janet R.;Haugen, Kara L.;Tang, Mei Tzu Chen;Porter, Peggy L.;Malone, Kathleen E.
妇女健康倡议（WHI）随机试验发现，使用联合雌激素和雌激素绝经激素治疗（CHT）增加乳腺癌的风险，但使用非对抗性雌激素治疗（EHT）不会。然而，关于激素使用对不同类型乳腺癌风险的影响以及使用的阈值会导致风险升高的几个问题仍然存在。我们在55-74岁的女性中进行了一项基于人群的病例对照研究，以评估绝经期激素使用与浸润性导管癌和浸润性小叶乳腺癌风险之间的关系。使用多分类逻辑回归分析评估相关性，分析包括880例导管病例，1，027例小叶病例和856例对照。目前EHT和CHT的使用分别与小叶乳腺癌风险增加1.6倍[95%置信区间（CI）：1.1-2.2]和2.3倍（95% CI：1.7-3.2）相关，但与导管癌风险无关。使用EHT九年后，小叶癌风险增加，但仅使用CHT三年后。十多项研究的证据表明，小叶癌是受更年期激素影响最大的乳腺癌类型。在这里，我们描述了EHT和CHT的使用持续时间的阈值，赋予风险升高。尽管激素治疗的使用迅速下降，WHI的结果已经公布，但考虑到美国每年仍有大约3800万份激素治疗处方，对这些药物相关危害的研究仍然具有重要意义。
The Women’s Health Initiative (WHI) randomized trials found that use of combined estrogen and progestin menopausal hormone therapy (CHT) increases breast cancer risk, but use of unopposed estrogen hormone therapy (EHT) does not. However, several questions regarding the impact of hormone use on risk of different types of breast cancer and what thresholds of use confer elevations in risk remain. We conducted a population-based case-control study among women 55–74 years of age to assess the association between menopausal hormone use and risk of invasive ductal and invasive lobular breast carcinomas. Associations were evaluated using polytomous logistic regression and analyses included 880 ductal cases, 1,027 lobular cases, and 856 controls. Current EHT and CHT use were associated with 1.6-fold [95% confidence interval (CI): 1.1–2.2] and 2.3-fold (95% CI: 1.7–3.2) increased risks of lobular breast cancer, respectively, but neither was associated with risk of ductal cancer. Lobular cancer risk was increased after nine years of EHT use, but after only three years of CHT use. Evidence across more than a dozen studies indicates that lobular carcinoma is the type of breast cancer most strongly influenced by menopausal hormones. Here we characterize what thresholds of duration of use of both EHT and CHT that confer elevations in risk. Despite the rapid decline in hormone therapy use the WHI results were published, study of the hazards associated with these medications remains relevant given the estimated 38 million hormone therapy prescriptions that are still filled in the United States annually.
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影响因子：
120.7
作者：
Chen, CL;Weiss, NS;White, E
通讯作者：
White, E
影响因子：
3.8
作者：
Li, Christopher I.;Daling, Janet R.
通讯作者：
Daling, Janet R.
影响因子：
5
作者：
VOIGT, LF;DAVIS, S;HEUSER, L
通讯作者：
HEUSER, L
影响因子：
2.7
作者：
BEGG, CB;GRAY, R
通讯作者：
GRAY, R
影响因子：
120.7
作者：
Chlebowski, RT;Hendrix, SL;McTiernan, A
通讯作者：
McTiernan, A