An overview of menopausal oestrogen-progestin hormone therapy and breast cancer risk.

An overview of menopausal oestrogen-progestin hormone therapy and breast cancer risk.
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DOI:
10.1038/sj.bjc.6602617
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发表时间:
2005-06-06
影响因子:
8.8
通讯作者:
--
中科院分区:
医学1区
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--
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妇女健康倡议 (WHI) 试验的结果支持观察性研究的结果,即雌激素-孕激素疗法 (EPT) 的使用与乳腺癌风险增加相关。我们利用乳腺癌激素因素合作小组 (CGHFBC) 汇总分析和自该报告发布以来发表的研究的 EPT 特异性结果进行了荟萃分析,以获得 EPT 使用和乳腺癌风险的概述。我们还根据乳腺癌的组织学亚型、EPT 中孕激素成分的时间表以及新近使用情况评估了风险。我们估计,总体而言,EPT 每年使用会使乳腺癌风险增加 7.6%。从统计上看,美国研究中的风险显着低于欧洲研究——分别为 5.2% 和 7.9%。在斯堪的纳维亚研究中,连续联合使用的孕激素总剂量比序贯 EPT 中使用的孕激素总剂量要高得多,连续联合使用的风险明显高于序贯 EPT。我们观察到小叶癌与导管癌的风险总体上没有差异,但确实观察到当前与过去使用 EPT 的风险稍高。
Results from the Women's Health Initiative (WHI) trial support findings from observational studies that oestrogen–progestin therapy (EPT) use is associated with an increase in breast cancer risk. We conducted a meta-analysis using EPT-specific results from the Collaborative Group on Hormonal Factors in Breast Cancer (CGHFBC) pooled analysis and studies published since that report to obtain an overview of EPT use and breast cancer risk. We also assessed risk by histologic subtype of breast cancer, by schedule of the progestin component of EPT, and by recency of use. We estimate that overall, EPT results in a 7.6% increase in breast cancer risk per year of use. The risk was statistically significantly lower in US studies than in European studies – 5.2 vs 7.9%. There was a significantly higher risk for continuous-combined than for sequential EPT use in Scandinavian studies where much higher total doses of progestin were used in continuous-combined than in sequential EPT. We observed no overall difference in risk for lobular vs ductal carcinoma but did observe a slightly higher risk for current vs past EPT use.
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