Dupont W D, Page D L, Parl F F, Plummer W D, Schuyler P A, Kasami M, Jensen R A
Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2637, USA.
Cancer. 1999 Mar 15;85(6):1277-83. doi: 10.1002/(sici)1097-0142(19990315)85:6<1277::aid-cncr9>3.0.co;2-e.
Little information is available regarding the invasive breast carcinoma risk associated with estrogen replacement therapy (ERT) in women with histories of histologically defined breast lesions.
A retrospective cohort study of a consecutive series of women who underwent breast biopsies that proved to be benign between 1952-1978 was conducted. Follow-up data were obtained for 9494 women (87.6% of women eligible for follow-up). To investigate the effect of ERT on invasive breast carcinoma risk, the analysis was restricted to women with premenopausal breast disease whose follow-up extended through menopause and who did not develop premenopausal breast carcinoma. Relative risks were calculated with respect to women who took ERT but whose benign breast biopsies had neither atypical hyperplasia (AH), complex fibroadenoma (CFA), nor proliferative disease without atypia (PDWA).
During 190,845 woman-years of follow-up there were 444 confirmed cases of invasive breast carcinoma in the entire cohort. Women with a history of AH had relative risks of invasive breast carcinoma of 2.87 (95% confidence interval [95% CI], 1.3-6.3) and 2.53 (95% CI, 1.0-6.3) if they did or did not take ERT, respectively. For women with a history of CFA these risks were 1.57 (95% CI, 0.72-3.4) and 1.46 (95% CI, 0.53-4.0), respectively, whereas for women with a history of PDWA they were 1.37 (95% CI, 0.88-2.1) and 1.13 (95% CI, 0.69-1.9), respectively.
ERT does not significantly elevate the risk of invasive breast carcinoma in women with previous histologically defined benign breast disease. Therefore, ERT is not contraindicated in these women.
关于组织学确诊的乳腺病变病史女性接受雌激素替代疗法（ERT）与浸润性乳腺癌风险之间的相关信息较少。
对1952年至1978年间连续一系列接受乳腺活检且结果证明为良性的女性进行回顾性队列研究。获得了9494名女性（ eligible for follow-up的87.6%）的随访数据。为研究ERT对浸润性乳腺癌风险的影响，分析仅限于绝经前乳腺疾病且随访持续至绝经且未发生绝经前乳腺癌的女性。相对于接受ERT但其良性乳腺活检既无非典型增生（AH）、复杂性纤维腺瘤（CFA）也无无异型性的增生性疾病（PDWA）的女性，计算相对风险。
在190845人年的随访期间，整个队列中有444例确诊的浸润性乳腺癌病例。有AH病史的女性，无论是否接受ERT，浸润性乳腺癌的相对风险分别为2.87（95%置信区间[95%CI]，1.3 - 6.3）和2.53（95%CI，1.0 - 6.3）。有CFA病史的女性，这些风险分别为1.57（95%CI，0.72 - 3.4）和1.46（95%CI，0.53 - 4.0），而有PDWA病史的女性，这些风险分别为1.37（95%CI，0.88 - 2.1）和1.13（95%CI，0.69 - 1.9）。
ERT不会显著提高既往组织学确诊为良性乳腺疾病女性的浸润性乳腺癌风险。因此，ERT在这些女性中并非禁忌。
