American Journal of Epidemiology Vol. 134, No. 12: 1375-1385
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Estrogen Replacement Therapy and the Risk of Breast Cancer: Results from the Case-Control Surveillance Study
1Slone Epidemiology Unit School of Public Health Boston University School of Medicine Brookline MA
2INSERM U292 Hopital de Bicetre Le Kremlin Bicetre Cedex France
3Department of Medicine Clinical Epidemiology Unit The University of Pennsylvania School of Medicine Philadelphia PA
4Cancer Care and Research Program New York Hospital Department of Public Health Cornell Medical Center New York NY
5Department of Epidemiology and Biostatistics Memorial Sloan-Kettering Cancer Center New York NY
Reprint requests to Dr. David W. Kaufman, Slone Epidemiology Unit, 1371 Beacon Street, Brookline, MA 02146
To examine the relation of noncontraceptive estrogen use to the risk of breast cancer among postmenopausal women, the authors conducted a case-control study: 1,686 cases were compared with 2,077 hospital control subjects, of whom 1,120 had non-gynecologic cancers and 957 had nonmalignant (also non-gynecologic) conditions. Data were obtained from 1980 to 1986, by interview of subjects in hospitals in the United States and Canada. The relative risk estimate for any use of replacement estrogens unopposed by progestogens was 1.2 (95% confidence interval (Cl) 1.0–1.4), after adjustment for age and type of menopause; when all known risk factors for breast cancer were taken into account in a multivariate analysis, the estimate was similar. For use of at least 15 years duration, the estimate was 0.9 (95% Cl 0.5–1.9). Most of the unopposed use was of conjugated estrogens: overall, the relative risk (95% Cl) was 1.3 (1.0–1.6); for durations of 15 or more years, it was 0.9 (0.4–1.9); for use of 5 years followed by a latent interval of 15 or more years, it was 1.3 (0.7–2.4); and for current use it was 1.1 (0.7–1.6). There was no evidence of increased breast cancer risk when the conjugated estrogen users were divided according to dose. There was little use of estrogens opposed by progestogens; the relative risk estimate was 1.7 (95% Cl 0.9–3.3). The results of this large study provide no evidence that the use of unopposed conjugated estrogens increases the risk of breast cancer, even after long durations of use or long latent intervals, but the possibility of a modest increase (less than a doubling) could not be excluded. There were insufficient data to evaluate the effects of noncon-jugated estrogens and of combined estrogen and progestogen therapy. Am J Epidemiol 1991;134:1375–85.
breast neoplasms; estrogen replacement therapy
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. M. Greiser, E. M. Greiser, and M. Doren Menopausal hormone therapy and risk of breast cancer: a meta-analysis of epidemiological studies and randomized controlled trials Hum. Reprod. Update, November 1, 2005; 11(6): 561 - 573. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Collins, J. M. Blake, and P. G. Crosignani Breast cancer risk with postmenopausal hormonal treatment Hum. Reprod. Update, November 1, 2005; 11(6): 545 - 560. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-L. Chen, N. S. Weiss, P. Newcomb, W. Barlow, and E. White Hormone Replacement Therapy in Relation to Breast Cancer JAMA, February 13, 2002; 287(6): 734 - 741. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Al-Azzawi The menopause and its treatment in perspective Postgrad. Med. J., May 1, 2001; 77(907): 292 - 304. [Full Text]
|
|
|
|
 |
|
 R. J. Santen, J. Pinkerton, C. McCartney, and G. R. Petroni Risk of Breast Cancer with Progestins in Combination with Estrogen as Hormone Replacement Therapy J. Clin. Endocrinol. Metab., January 1, 2001; 86(1): 16 - 23. [Full Text]
|
|
|
|
|
|
T. L. Bush and M. K. Whiteman Hormone Replacement Therapy and Risk of Breast Cancer JAMA, June 9, 1999; 281(22): 2140 - 2141. [Full Text] [PDF]
|
|
|
|
|
|
J. A. Cauley, F. L. Lucas, L. H. Kuller, M. T. Vogt, W. S. Browner, and S. R. Cummings Bone Mineral Density and Risk of Breast Cancer in Older Women: The Study of Osteoporotic Fractures JAMA, November 6, 1996; 276(17): 1404 - 1408. [Abstract] [PDF]
|
|
|
|
 |
|
 R. D. Gambrell Jr Hormone Replacement Therapy and Breast Cancer Risk Arch Fam Med, June 1, 1996; 5(6): 341 - 348. [Abstract] [PDF]
|
|
|
|
|
|
R. E. Harris, K. K. Namboodiri, W. B. Farrar, S. M. Solano, and E. L. Wynder Hormone Replacement Therapy and Breast Cancer Risk JAMA, April 17, 1996; 275(15): 1158 - 1159. [Abstract] [PDF]
|
|
|
|
 |
|
 G. A. Colditz Postmenopausal Estrogens and Breast Cancer Reproductive Sciences, March 1, 1996; 3(2): 50 - 56. [PDF]
|
|
|
|
|
|
J. L. Stanford, N. S. Weiss, L. F. Voigt, J. R. Daling, L. A. Habel, and M. A. Rossing Combined Estrogen and Progestin Hormone Replacement Therapy in Relation to Risk of Breast Cancer in Middle-aged Women JAMA, July 12, 1995; 274(2): 137 - 142. [Abstract] [PDF]
|
|
|
|
 |
|
 G. A. Colditz, S. E. Hankinson, D. J. Hunter, W. C. Willett, J. E. Manson, M. J. Stampfer, C. Hennekens, B. Rosner, and F. E. Speizer The Use of Estrogens and Progestins and the Risk of Breast Cancer in Postmenopausal Women N. Engl. J. Med., June 15, 1995; 332(24): 1589 - 1593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K. Steinberg and S. J. Smith Breast Cancer and Estrogen Therapy-Reply JAMA, October 5, 1994; 272(13): 1004 - 1005. [Abstract] [PDF]
|
|
|
|
|
|
M. A. Cobleigh, R. F. Berris, T. Bush, N. E. Davidson, N. J. Robert, J. A. Sparano, D. C. Tormey, W. C. Wood, Breast Cancer Committees of the Eastern Cooperativ, R. F. Berris, et al. Estrogen Replacement Therapy in Breast Cancer Survivors: A Time for Change JAMA, August 17, 1994; 272(7): 540 - 545. [Abstract] [PDF]
|
|
|
|
 |
|
 D G R Evans, I S Fentiman, K McPherson, D Asbury, B A J Ponder, and A Howell Fortnightly Review: Familial breast cancer BMJ, January 15, 1994; 308(6922): 183 - 187. [Abstract] [Full Text]
|
|
|
|
|
|
D. Grady and S. M. Rubin The Postmenopausal Estrogen/Breast Cancer Controversy JAMA, February 24, 1993; 269(8): 990 - 990. [Abstract] [PDF]
|
|
|
|
|
|
J. B. Henrich The Postmenopausal Estrogen/Breast Cancer Controversy-Reply JAMA, February 24, 1993; 269(8): 991 - 991. [Abstract] [PDF]
|
|
|
|
 |
|
 D. Grady, S. M. Rubin, D. B. Petitti, C. S. Fox, D. Black, B. Ettinger, V. L. Ernster, and S. R. Cummings Hormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women Ann Intern Med, December 15, 1992; 117(12): 1016 - 1037. [Abstract] [PDF]
|
|
|
|
|
|
J. B. Henrich The Postmenopausal Estrogen/Breast Cancer Controversy JAMA, October 14, 1992; 268(14): 1900 - 1902. [Abstract] [PDF]
|
|