Hormone replacement therapy after a diagnosis of breast cancer in relation to recurrence and mortality.

التفاصيل البيبلوغرافية
العنوان:	Hormone replacement therapy after a diagnosis of breast cancer in relation to recurrence and mortality.
المؤلفون:	O'Meara ES; Fred Hutchinson Cancer Research Center and Department of Epidemiology, University of Washington, Seattle, USA. eomeara@u.washington.edu, Rossing MA, Daling JR, Elmore JG, Barlow WE, Weiss NS
المصدر:	Journal of the National Cancer Institute [J Natl Cancer Inst] 2001 May 16; Vol. 93 (10), pp. 754-62.
نوع المنشور:	Journal Article; Research Support, U.S. Gov't, P.H.S.
اللغة:	English
بيانات الدورية:	Publisher: Oxford University Press Country of Publication: United States NLM ID: 7503089 Publication Model: Print Cited Medium: Print ISSN: 0027-8874 (Print) Linking ISSN: 00278874 NLM ISO Abbreviation: J Natl Cancer Inst Subsets: MEDLINE
أسماء مطبوعة:	Publication: <2003-> : Cary, NC : Oxford University Press Original Publication: Bethesda, Md., U. S. Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health; Washington, for sale by the Supt. of Docs., U. S. Govt. Print. Off.
مواضيع طبية MeSH:	Breast Neoplasms/drug therapy , Breast Neoplasms/mortality , Hormone Replacement Therapy/*adverse effects, Adult ; Aged ; Breast Neoplasms/etiology ; Case-Control Studies ; Female ; Humans ; Menopause ; Middle Aged ; Models, Statistical ; Recurrence ; Risk
مستخلص:	Background: Hormone replacement therapy (HRT) is typically avoided for women with a history of breast cancer because of concerns that estrogen will stimulate recurrence. In this study, we sought to evaluate the impact of HRT on recurrence and mortality after a diagnosis of breast cancer. Methods: Data were assembled from 2755 women aged 35-74 years who were diagnosed with incident invasive breast cancer while they were enrolled in a large health maintenance organization from 1977 through 1994. Pharmacy data identified 174 users of HRT after diagnosis. Each HRT user was matched to four randomly selected nonusers of HRT with similar age, disease stage, and year of diagnosis. Women in the analysis were recurrence free at HRT initiation or the equivalent time since diagnosis. Rates of recurrence and death through 1996 were calculated. Adjusted relative risks were estimated by use of the Cox regression model. All statistical tests were two-sided. Results: The rate of breast cancer recurrence was 17 per 1000 person-years in women who used HRT after diagnosis and 30 per 1000 person-years in nonusers (adjusted relative risk for users compared with nonusers = 0.50; 95% confidence interval [CI] = 0.30 to 0.85). Breast cancer mortality rates were five per 1000 person-years in HRT users and 15 per 1000 person-years in nonusers (adjusted relative risk = 0.34; 95% CI = 0.13 to 0.91). Total mortality rates were 16 per 1000 person-years in HRT users and 30 per 1000 person-years in nonusers (adjusted relative risk = 0.48; 95% CI = 0.29 to 0.78). The relatively low rates of recurrence and death were observed in women who used any type of HRT (oral only = 41% of HRT users; vaginal only = 43%; both oral and vaginal = 16%). No trend toward lower relative risks was observed with increased dose. Conclusion: We observed lower risks of recurrence and mortality in women who used HRT after breast cancer diagnosis than in women who did not. Although residual confounding may exist, the results suggest that HRT after breast cancer has no adverse impact on recurrence and mortality.
التعليقات:	Comment in: J Natl Cancer Inst. 2001 May 16;93(10):733-4. (PMID: 11353776)
معلومات مُعتمدة:	5T32CA09168 United States CA NCI NIH HHS; N01CN67009 United States CN NCI NIH HHS
تواريخ الأحداث:	Date Created: 20010517 Date Completed: 20010621 Latest Revision: 20190513
رمز التحديث:	20240627
DOI:	10.1093/jnci/93.10.754
PMID:	11353785
قاعدة البيانات:	MEDLINE

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تدمد:	0027-8874
DOI:	10.1093/jnci/93.10.754