Byrne C, Connolly J L, Colditz G A, Schnitt S J
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Cancer. 2000 Nov 15;89(10):2046-52. doi: 10.1002/1097-0142(20001115)89:10<2046::aid-cncr3>3.0.co;2-f.
A history of proliferative benign breast disease has been shown to increase the risk of developing breast carcinoma, but, to the authors' knowledge, how postmenopausal exogenous female hormone use, in general, has affected breast carcinoma risk among women with a history of proliferative breast disease with or without atypia has not been well established.
In the current case-control study, nested within the Nurses' Health Study, benign breast biopsy slides of 133 postmenopausal breast carcinoma cases and 610 controls with a history of benign breast disease, were reviewed. Reviewers had no knowledge of case status.
Women with proliferative disease without atypia had a relative risk for postmenopausal breast carcinoma of 1.8 (95%, confidence interval [CI]: 1.1 to 2.8), and women with atypical hyperplasia had a relative risk of 3.6 (95%, CI: 2.0 to 6.4) compared with women who had nonproliferative benign histology. Neither current postmenopausal use of exogenous female hormones nor long term use for 5 or more years further increased the risk of breast carcinoma in the study population beyond that already associated with their benign histology.
Women who had proliferative benign breast disease, with or without atypia, were at moderately to substantially increased risk of developing postmenopausal breast carcinoma compared with women who had nonproliferative benign conditions. In the current study, postmenopausal exogenous female hormone use in general did not further increase the breast carcinoma risk for women with proliferative benign breast disease. However, the analysis did not exclude the possibility of increased risk with a particular hormone combination or dosage.
增生性良性乳腺疾病史已被证明会增加患乳腺癌的风险，但据作者所知，绝经后使用外源性女性激素总体上如何影响有或无非典型增生的增生性乳腺疾病史女性的乳腺癌风险尚未明确。
在当前这项嵌套于护士健康研究中的病例对照研究中，对133例绝经后乳腺癌病例和610例有良性乳腺疾病史的对照的良性乳腺活检切片进行了复查。复查人员对病例状态不知情。
与非增生性良性组织学的女性相比，有非典型增生的增生性疾病女性绝经后患乳腺癌的相对风险为1.8（95%置信区间[CI]：1.1至2.8），非典型增生女性的相对风险为3.6（95%CI：2.0至6.4）。在研究人群中，当前绝经后使用外源性女性激素以及使用5年或更长时间均未使乳腺癌风险在与其良性组织学相关的风险基础上进一步增加。
与非增生性良性疾病的女性相比，有或无非典型增生的增生性良性乳腺疾病女性患绝经后乳腺癌的风险中度至大幅增加。在当前研究中，绝经后总体使用外源性女性激素并未进一步增加增生性良性乳腺疾病女性的乳腺癌风险。然而，该分析并未排除特定激素组合或剂量会增加风险的可能性。
