 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
1 December 1997 | Volume 127 Issue 11 | Pages 973-980
Background: The risks and benefits of hormone replacement therapy (HRT) are of considerable interest and importance, especially in terms of whether they differ among subsets of women.
Objective: To determine whether HRT is associated with increased risks for breast cancer and total mortality in women with a family history of breast cancer.
Design: Prospective cohort study.
Setting: Population-based sample of midwestern postmenopausal women enrolled in an observational study of risk factors for cancer.
Participants: Random sample of 41 837 female Iowa residents 55 to 69 years of age.
Measurements: Incidence rates of and relative risks for breast cancer (n = 1085) and total mortality (n = 2035) through 8 years of follow-up were calculated by using data from the State Health Registry of Iowa and the National Death Index.
Results: A family history of breast cancer was reported by 12.2% of the cohort at risk. Among women with a family history of breast cancer, those who currently used HRT and had done so for at least 5 years developed breast cancer at an age-adjusted annual rate of 61 cases per 10 000 person-years (95% CI, 28 to 94 cases); this rate was not statistically significantly higher than the rate in women who had never used HRT (46 cases per 10 000 person-years [CI, 36 to 55 cases]). Among women with a family history, those who used HRT had a significantly lower risk for total mortality than did women who had never used HRT (relative risk, 0.67 [CI, 0.51 to 0.89]), including total cancer-related mortality (relative risk, 0.75 [CI, 0.50 to 1.12]). The age-adjusted annual mortality rate for women using HRT for at least 5 years was 46 deaths per 10 000 person-years (CI, 19 to 74 deaths); this is roughly half the rate seen in women who had never used HRT (80 deaths per 10 000 person-years [CI, 69 to 92 deaths]).
Conclusions: These data suggest that HRT use in women with a family history of breast cancer is not associated with a significantly increased incidence of breast cancer but is associated with a significantly reduced total mortality rate.
Author and Article Information
From the University of Minnesota, Minneapolis, Minnesota; and the University of Iowa, Iowa City, Iowa.
ARTICLE
The Role of Hormone Replacement Therapy in the Risk for Breast Cancer and Total Mortality in Women with a Family History of Breast Cancer
Disclaimer: The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.
Grant Support: By grant R01 CA39742 from the U.S. National Cancer Institute. Ms. Mink was supported by a training grant (T32CA09607) from the National Cancer Institute to Dr. Les Robison.
Requests for Reprints: Thomas A. Sellers, PhD, Division of Epidemiology, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454.
Current Author Addresses: Drs. Sellers, Zheng, Anderson, Kushi, and Folsom and Ms. Mink: Division of Epidemiology, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  P. A. Newcomb, K. M. Egan, A. Trentham-Dietz, L. Titus-Ernstoff, J. A. Baron, J. M. Hampton, M. J. Stampfer, and W. C. Willett Prediagnostic Use of Hormone Therapy and Mortality After Breast Cancer Cancer Epidemiol. Biomarkers Prev., April 1, 2008; 17(4): 864 - 871. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 M. Dietel, M.A. Lewis, and S. Shapiro Hormone replacement therapy: pathobiological aspects of hormone-sensitive cancers in women relevant to epidemiological studies on HRT: a mini-review Hum. Reprod., August 1, 2005; 20(8): 2052 - 2060. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U.S. Preventive Services Task Force* Hormone Therapy for the Prevention of Chronic Conditions in Postmenopausal Women: Recommendations from the U.S. Preventive Services Task Force Ann Intern Med, May 17, 2005; 142(10): 855 - 860. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
ESHRE Capri Workshop Group Hormones and breast cancer Hum. Reprod. Update, July 1, 2004; 10(4): 281 - 293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Pappo, I. Meirshon, T. Karni, N. Siegelmann-Danielli, V. Stahl-Kent, J. Sandbank, I. Wasserman, and A. Halevy The Characteristics of Malignant Breast Tumors in Hormone Replacement Therapy Users Versus Nonusers Ann. Surg. Oncol., January 1, 2004; 11(1): 52 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kerlikowske, D. L. Miglioretti, R. Ballard-Barbash, D. L. Weaver, D. S.M. Buist, W. E. Barlow, G. Cutter, B. M. Geller, B. Yankaskas, S. H. Taplin, et al. Prognostic Characteristics of Breast Cancer Among Postmenopausal Hormone Users in a Screened Population J. Clin. Oncol., December 1, 2003; 21(23): 4314 - 4321. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. H. Humphries and S. Gill Risks and benefits of hormone replacement therapy: The evidence speaks Can. Med. Assoc. J., April 15, 2003; 168(8): 1001 - 1010. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Pichert, B. Bolliger, K. Buser, and O. Pagani Evidence-based management options for women at increased breast/ovarian cancer risk Ann. Onc., January 1, 2003; 14(1): 9 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U.S. Preventive Services Task Force* Postmenopausal Hormone Replacement Therapy for Primary Prevention of Chronic Conditions: Recommendations and Rationale Ann Intern Med, November 19, 2002; 137(10): 834 - 839. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. R. Freedman, M. Kleerekoper, and D. Grady A Woman Attempting to Discontinue Hormone Therapy JAMA, November 13, 2002; 288(18): 2264 - 2265. [Full Text] [PDF]
|
|
|
|
|
|
H. D. Nelson, L. L. Humphrey, P. Nygren, S. M. Teutsch, and J. D. Allan Postmenopausal Hormone Replacement Therapy: Scientific Review JAMA, August 21, 2002; 288(7): 872 - 881. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. D. Nelson Assessing Benefits and Harms of Hormone Replacement Therapy: Clinical Applications JAMA, August 21, 2002; 288(7): 882 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. McNagny, N. K. Wenger, N. Hilmy, S. Banarer, M. Barton, R. K. Dubey, S. R. Davis, J. E. Manson, and K. A. Martin Postmenopausal Hormone-Replacement Therapy N. Engl. J. Med., January 3, 2002; 346(1): 63 - 65. [Full Text] [PDF]
|
|
|
|
 |
|
 V. C. Jordan, S. Gapstur, and M. Morrow Selective Estrogen Receptor Modulation and Reduction in Risk of Breast Cancer, Osteoporosis, and Coronary Heart Disease J Natl Cancer Inst, October 3, 2001; 93(19): 1449 - 1457. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. L. Bush, M. Whiteman, and J. A. Flaws Hormone Replacement Therapy and Breast Cancer: A Qualitative Review Obstet. Gynecol., September 1, 2001; 98(3): 498 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Rozenberg, H. Ham, and L. Mosca The Role of HRT in Cardiovascular Disease Arch Intern Med, March 12, 2001; 161(5): 773 - 773. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Rodriguez, E. E. Calle, A. V. Patel, L. M. Tatham, E. J. Jacobs, and M. J. Thun Effect of Body Mass on the Association between Estrogen Replacement Therapy and Mortality among Elderly US Women Am. J. Epidemiol., January 15, 2001; 153(2): 145 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. F. ARCHER and J. H. PICKAR Hormone Replacement Therapy: Effect of Progestin Dose and Time Since Menopause on Endometrial Bleeding Obstet. Gynecol., December 1, 2000; 96(6): 899 - 905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Mosca The Role of Hormone Replacement Therapy in the Prevention of Postmenopausal Heart Disease Arch Intern Med, August 14, 2000; 160(15): 2263 - 2272. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Armstrong, A. Eisen, and B. Weber Assessing the Risk of Breast Cancer N. Engl. J. Med., February 24, 2000; 342(8): 564 - 571. [Full Text] [PDF]
|
|
|
|
|
|
W. Levinson and D. Altkorn Primary Prevention of Postmenopausal Osteoporosis JAMA, December 2, 1998; 280(21): 1821 - 1822. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Baron, G. B. Holzman, and J. Schulkin Attitudes of Obstetricians and Gynecologists toward Hormone Replacement Therapy Med Decis Making, October 1, 1998; 18(4): 406 - 411. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Rousseau The homeless terminally ill and hospice & palliative care American Journal of Hospice and Palliative Medicine, July 1, 1998; 15(4): 196 - 197. [PDF]
|
|
|
|
 |
|
 Hormone Therapy and Familial Breast Cancer Journal Watch Women's Health, February 1, 1998; 1998(201): 1 - 1. [Full Text]
|
|
|
|
 |
|
 HRT AND FAMILY HISTORY OF BREAST CANCER Journal Watch (General), December 23, 1997; 1997(1223): 2 - 2. [Full Text]
|
|
Article
