|
|
How to judge the association of postmenopausal hormone therapy and the risk of breast cancer |
Ling XU() |
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China |
|
|
Abstract The relevance of postmenopausal hormone therapy (HT) for breast cancer risk has been long debated, although it is one of the most important barriers for women to accept HT. Various opinions have been reported from recent randomized clinical trials and epidemiological studies. These unanswered questions include: whether HT has a positive impact on breast cancer; whether risks of therapy with unopposed estrogen and combined estrogen-progestin are different; and whether different types and routes of estrogen and progestogens, as well as the duration and cessation of HT use, have different impacts on this disorder. Recently, there has been some good news such as the following: the currently available data do not provide sufficient evidence to prove a causal relationship between postmenopausal HT and breast cancer; breast cancer in postmenopausal women using HT usually has better prognosis than that of nonusers. In conclusion, HT is still the most effective method of relieving climacteric symptoms for many postmenopausal women. However, a possible risk of breast cancer associated with long-term HT usage should not be ignored. With respect to prevention of breast cancer, regular evaluation of individual breast cancer susceptibility and close follow-up through mammography and/or breast sonography are necessary strategies for the safety of HT use.
|
Keywords
breast cancer
postmenopausal hormone therapy
unopposed estrogen therapy
combined estrogen-progestin therapy
|
Corresponding Author(s):
XU Ling,Email:xuling@pumch.cn
|
Issue Date: 05 September 2010
|
|
1 |
Verkooijen H M, Bouchardy C, Vinh-Hung V, Rapiti E, Hartman M. The incidence of breast cancer and changes in the use of hormone replacement therapy: a review of the evidence. Maturitas , 2009, 64(2): 80–85 doi: 10.1016/j.maturitas.2009.07.015
|
2 |
Sharpe K H, McClements P, Clark D I, Collins J, Springbett A, Brewster D H. Reduced risk of oestrogen receptor positive breast cancer among peri- and post-menopausal women in Scotland following a striking decrease in use of hormone replacement therapy. Eur J Cancer , 2010, 46(5): 937–943 doi: 10.1016/j.ejca.2010.01.003
|
3 |
Parkin D M. Is the recent fall in incidence of post-menopausal breast cancer in UK related to changes in use of hormone replacement therapy? Eur J Cancer , 2009, 45(9): 1649–1653 doi: 10.1016/j.ejca.2009.01.016
|
4 |
Katalinic A, Lemmer A, Zawinell A, Rawal R, Waldmann A. Trends in hormone therapy and breast cancer incidence– results from the German Network of Cancer Registries. Pathobiology , 2009, 76(2): 90–97 doi: 10.1159/000201677
|
5 |
Jemal A, Ward E, Thun M. Recent trends in breast cancer incidence rates by age and tumor characteristics among US women. Breast Cancer Res , 2007, 9(3): 108 doi: 10.1186/bcr1672
|
6 |
Canfell K, Banks E, Moa A M, Beral V. Decrease in breast cancer incidence following a rapid fall in use of hormone replacement therapy in Australia. Med J Aust , 2008, 188(11): 641–644
|
7 |
Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progesterone in healthy post-menopausal women. JAMA , 2002, 288(3): 321–333
|
8 |
Huang K E, Xu L, I N N, Jaisamrarn U. The Asian Menopause Survey: knowledge, perceptions, hormone treatment and sexual function. Maturitas , 2010, 65(3): 276–283 doi: 10.1016/j.maturitas.2009.11.015
|
9 |
Gramling R, Eaton C B, Rothman K J, Cabral H, Silliman R A, Lash T L. Hormone replacement therapy, family history, and breast cancer risk among postmenopausal women. Epidemiology , 2009, 20(5): 752–756 doi: 10.1097/EDE.0b013e3181a71279
|
10 |
Pines A, Sturdee D W, Birkh?user M H, Schneider H P, Gambacciani M, Panay N. IMS updated recommendations on postmenopausal hormone therapy. Climacteric , 2007, 10(3): 181–194 doi: 10.1080/13697130701361657
|
11 |
Bush T L, Whiteman M, Flaws J A. Hormone replacement therapy and breast cancer: a qualitative review. Obstet Gynecol , 2001, 98(3): 498–508 doi: 10.1016/S0029-7844(01)01453-3
|
12 |
Chlebowski R T, Hendrix S L, Langer R D, Stefanick M L, Gass M, Lane D, Rodabough R J, Gilligan M A, Cyr M G, Thomson C A, Khandekar J, Petrovitch H, McTiernan A; WHI Investigators. Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women’s Health Initiative randomized trial. JAMA , 2003, 289(24): 3243–3253
|
13 |
Beral V, for the Million Women Study Collaborators. Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet , 2003, 362(9382): 419–427 doi: 10.1016/S0140-6736(03)14065-2
|
14 |
Anderson G L, Limacher M, Assaf A R, Bassford T, Beresford S A, Black H, Bonds D, Brunner R, Brzyski R, Caan B, Chlebowski R, Curb D, Gass M, Hays J, Heiss G, Hendrix S, Howard B V, Hsia J, Hubbell A, Jackson R, Johnson K C, Judd H, Kotchen J M, Kuller L, LaCroix A Z, Lane D, Langer R D, Lasser N, Lewis C E, Manson J, Margolis K, Ockene J, O'Sullivan M J, Phillips L, Prentice R L, Ritenbaugh C, Robbins J, Rossouw J E, Sarto G, Stefanick M L, Van Horn L, Wactawski-Wende J, Wallace R, Wassertheil-Smoller S; Women's Health Initiative Steering Committee. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy. JAMA , 2004, 291(14): 1701–1712
|
15 |
Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Lancet , 1997, 350(9084): 1047-1059 Erratum in. Lancet , 1997, 350(9089): 1484 doi: 10.1016/S0140-6736(05)64259-6
|
16 |
Li C I, Malone K E, Porter P L, Weiss N S, Tang M T, Cushing-Haugen K L, Daling J R. Relationship between long durations and different regimens of hormone therapy and risk of breast cancer. JAMA , 2003, 289(24): 3254–3263
|
17 |
Gadducci A, Biglia N, Cosio S, Sismondi P, Genazzani A R. Progestagen component in combined hormone replacement therapy in postmenopausal women and breast cancer risk: a debated clinical issue. Gynecol Endocrinol , 2009, 25(12): 807–815 doi: 10.3109/09513590903056878
|
18 |
Santen R J. Does menopausal hormone therapy initiate new breast cancers or promote the growth of existing ones? Womens Health (Lond Engl) , 2008, 4(3): 207–210 doi: 10.2217/17455057.4.3.207
|
19 |
Jernstr?m H, Frenander J, Fern? M, Olsson H. Hormone replacement therapy before breast cancer diagnosis significantly reduces the overall death rate compared with never-use among 984 breast cancer patients. Br J Cancer , 1999, 80(9): 1453–1458 doi: 10.1038/sj.bjc.6690543
|
20 |
Nanda K, Bastian L A, Schulz K. Hormone replacement therapy and the risk of death from breast cancer: a systematic review. Am J Obstet Gynecol , 2002, 186(2): 325–334 doi: 10.1067/mob.2002.121077
|
21 |
Chen W Y, Manson J E, Hankinson S E, Rosner B, Holmes M D, Willett W C, Colditz G A. Unopposed estrogen therapy and the risk of invasive breast cancer. Arch Intern Med , 2006, 166(9): 1027–1032 doi: 10.1001/archinte.166.9.1027
|
22 |
Fowble B, Hanlon A, Freedman G, Patchefsky A, Kessler H, Nicolaou N, Hoffman J, Sigurdson E, Boraas M, Goldstein L. Postmenopausal hormone replacement therapy: effect on diagnosis and outcome in early-stage invasive breast cancer treated with conservative surgery and radiation. J Clin Oncol , 1999, 17(6): 1680–1688
|
23 |
Chlebowski R T, Kuller L H, Prentice R L, Stefanick M L, Manson J E, Gass M, Aragaki A K, Ockene J K, Lane D S, Sarto G E, Rajkovic A, Schenken R, Hendrix S L, Ravdin P M, Rohan T E, Yasmeen S, Anderson G, for the WHI Investigators. Breast cancer after use of estrogen plus progestin in postmenopausal women. N Engl J Med , 2009, 360(6): 573–587 doi: 10.1056/NEJMoa0807684
|
|
Viewed |
|
|
|
Full text
|
|
|
|
|
Abstract
|
|
|
|
|
Cited |
|
|
|
|
|
Shared |
|
|
|
|
|
Discussed |
|
|
|
|