HRT USE AND RISK OF LOBULAR AND DUCTAL BREAST CANCER

描述(改编自申请人的摘要)：发病率 浸润性小叶乳腺癌(ILBC)在美国稳步增加。 自1977年以来，乳腺导管疾病的发病率呈上升趋势 癌症自1987年以来一直停滞不前。这种小叶肿瘤的上升已经发生了 尤其是在50岁以上的女性中。雌孕激素联合用药的应用 激素替代疗法(CHRT)在这段时间里也稳步上升。 最近对两个病例对照调查的分析表明 使用CHRT的绝经后妇女患ILBC的风险可能会增加，而 CHRT与导管癌无相关性。很少有流行病学研究 评估了乳腺癌的已知或疑似危险因素有何不同 不同的组织学类型，但这样的研究很重要 因为可能会有多条道路通向发展和 不同组织学类型乳腺癌的进展。 这项拟议研究的主要目标是确认最近的初步 研究发现，CHRT与大叶性乳腺癌有关 以人口为基础的研究，更详细地评估这种关系，并 探索这种联系的机制。 我们建议对900名年龄在55-79岁之间的女性进行病例对照研究 被诊断为乳腺癌(450例小叶癌，450例导管癌)和450例乳腺癌 居住在西雅图-普吉特湾三县的人口控制人员 华盛顿州西部的大都市区。要解决的具体问题 是：(1)慢性阻塞性肺疾病的使用是否与发病率的增加有关？ 55-79岁女性浸润性小叶性乳腺癌。(2)CHRT的使用情况 与浸润性导管癌发病率增加有关 在55-79岁的女性中？(3)使用CHRT的持续时间、模式和/或近期 影响协会的规模？(4)CHRT的使用是否与 组织学特征改变，肿瘤细胞增殖，或 类固醇激素受体、癌基因的表达与细胞周期和细胞 小叶和导管乳腺癌的死亡调节蛋白？

DESCRIPTION (Adapted from the Applicant's Abstract): Incidence rates of invasive lobular breast carcinomas (ILBC) have increased steadily in the United States since 1977, whereas the trend of increasing incidence of ductal breast cancer has plateaued since 1987. This rise in lobular tumors has occurred specifically among women over age 50. The use of combined estrogen-progestin hormone replacement therapy (CHRT) has also risen steadily over this time period, and recent analyses from two case-control investigations suggest that postmenopausal women who use CHRT may have an increased risk of ILBC, whereas there is no relationship of CHRT to ductal cancer. Few epidemiologic studies have assessed how known or suspected risk factors for breast cancer differ across different histologic types, but such investigations are important because there are likely to be multiple pathways leading to the development and progression of breast cancer of different histologic types. The primary objectives of this proposed study are to confirm recent preliminary findings that CHRT is associated with lobular breast cancer in a large population-based study, to assess this relationship in greater detail, and to explore mechanisms for this association. We propose to conduct a case-control study of 900 women aged 55-79 who have been diagnosed with breast cancer (450 lobular, 450 ductal) and 450 population-based controls who reside in the three county Seattle-Puget Sound metropolitan area of western Washington. The specific questions to be addressed are: (1) Is the use of CHRT associated with an increase in the incidence of invasive lobular breast cancer in women aged 55-79. (2) Is the use of CHRT associated with an increase in the incidence of invasive ductal breast cancer in women aged 55-79? (3) Do the duration, patterns and/or recency of CHRT use influence he size of the association? (4) Is the use of CHRT associated with alteration in the histologic characteristics, tumor cell proliferation, or expression of steroid hormone receptors, oncogenes, and cell cycle and cell death regulator proteins of lobular and ductal breast cancers?