Newcomer Laura M, Newcomb Polly A, Potter John D, Yasui Yutaka, Trentham-Dietz Amy, Storer Barry E, Longnecker Matthew P, Baron John A, Daling Janet R
Program in Epidemiology, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Cancer Causes Control. 2003 Apr;14(3):225-33. doi: 10.1023/a:1023634907723.
Postmenopausal hormone use and risk of breast cancer by histopathology was examined in a large multi-centered population-based case-control study.
Women younger than 75 years newly diagnosed with invasive breast cancer between 1988 and 1991 were identified from statewide tumour registries in Wisconsin, Massachusetts, New Hampshire, and Maine. Only postmenopausal women were included in this analysis. Breast cancer cases (lobular (n = 219), ductal, NOS (n = 2172), and specific ductal subtypes (n = 242)) were compared with randomly selected population controls (n = 3179) using adjusted multi-variable polytomous logistic regression to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for each histology.
Lobular carcinoma was associated with recent (within 2 years) estrogen therapy (OR: 1.8, 95% CI: 1.0-3.4) and recent use of combined estrogen-plus-progestin therapy (OR:3.6, 95%CI: 1.8-7.6). Risk of ductal carcinoma was not associated with recent use of either estrogen alone (OR: 0.9, 95% CI: 0.7-1.2) or combined therapy (OR:0.9, 95% CI: 0.6-1.3). No associations were found with ductal subtypes.
The association between postmenopausal hormone use and risk of breast cancer may depend on histopathology. Of particular interest is the association between combined hormone therapy and increased risk of lobular carcinoma. This lesion is increasingly common but, nonetheless, comprises fewer than 10% of invasive breast cancers.
在一项大型多中心基于人群的病例对照研究中，探讨绝经后激素使用与组织病理学类型的乳腺癌风险之间的关系。
从威斯康星州、马萨诸塞州、新罕布什尔州和缅因州的全州肿瘤登记处识别出1988年至1991年间新诊断为浸润性乳腺癌的75岁以下女性。本分析仅纳入绝经后女性。使用调整后的多变量多分类逻辑回归，将乳腺癌病例（小叶癌（n = 219）、导管癌，未特指（n = 2172）和特定导管亚型（n = 242））与随机选择的人群对照（n = 3179）进行比较，以估计每种组织学类型的比值比（OR）和95%置信区间（95%CI）。
小叶癌与近期（2年内）雌激素治疗（OR：1.8，95%CI：1.0 - 3.4）和近期使用雌激素加孕激素联合治疗（OR：3.6，95%CI：1.8 - 7.6）相关。导管癌风险与近期单独使用雌激素（OR：0.9，95%CI：0.7 - 1.2）或联合治疗（OR：0.9，95%CI：0.6 - 1.3）均无关。未发现与导管亚型有关联。
绝经后激素使用与乳腺癌风险之间的关联可能取决于组织病理学类型。特别值得关注的是联合激素治疗与小叶癌风险增加之间的关联。这种病变越来越常见，但在浸润性乳腺癌中仍占不到10%。
