Stahlberg C, Pedersen A T, Andersen Z J, Keiding N, Hundrup Y A, Obel E B, Møller S, Rank F, Ottesen B, Lynge E
Department of Gynaecology and Obstetrics, Juliane Marie Centre, H:S Rigshospitalet, University of Copenhagen, Denmark.
Br J Cancer. 2004 Aug 16;91(4):644-50. doi: 10.1038/sj.bjc.6601996.
The aim of this study is to investigate the risk of developing prognostic different types of breast cancer in women using hormone replacement therapy (HRT). A total of 10 874 postmenopausal Danish Nurses were followed since 1993. Incident breast cancer cases and histopathological information were retrieved through the National Danish registries. The follow-up ended on 31 December 1999. Breast cancer developed in 244 women, of whom 172 were invasive ductal carcinomas. Compared to never users, current users of HRT had an increased risk of a hormone receptor-positive breast cancer, but a neutral risk of receptor-negative breast cancer, relative risk (RR) 3.29 (95% confidence interval (CI): 2.27-4.77) and RR 0.99 (95% CI: 0.42-2.36), respectively (P for difference=0.013). The risk of being diagnosed with low histological malignancy grade was higher than high malignancy grade with RR 4.13 (95% CI: 2.43-7.01) and RR 2.17 (95% CI: 1.42-3.30), respectively (P=0.063). For breast cancers with other prognostic characteristics, the risk was increased equally for the favourable and non favourable types. Current users of HRT experience a two- to four-fold increased risk of breast cancer with various prognostic characteristics, both the favourable and non favourable types. For receptor status, the risk with HRT was statistically significantly higher for hormone receptor-positive breast cancer compared to receptor-negative breast cancer.
本研究的目的是调查使用激素替代疗法(HRT)的女性患不同预后类型乳腺癌的风险。自1993年以来,对总共10874名丹麦绝经后护士进行了随访。通过丹麦国家登记处获取了乳腺癌发病病例和组织病理学信息。随访于1999年12月31日结束。244名女性患了乳腺癌,其中172例为浸润性导管癌。与从未使用过HRT的女性相比,当前使用HRT的女性患激素受体阳性乳腺癌的风险增加,但患受体阴性乳腺癌的风险为中性,相对风险(RR)分别为3.29(95%置信区间(CI):2.27 - 4.77)和RR 0.99(95%CI:0.42 - 2.36)(差异P = 0.013)。被诊断为低组织学恶性程度等级的风险高于高恶性程度等级,RR分别为4.13(95%CI:2.43 - 7.01)和RR 2.17(95%CI:1.42 - 3.30)(P = 0.063)。对于具有其他预后特征的乳腺癌,有利类型和不利类型的风险增加程度相同。当前使用HRT的女性患具有各种预后特征(包括有利类型和不利类型)的乳腺癌的风险增加了两到四倍。对于受体状态,与受体阴性乳腺癌相比,HRT导致激素受体阳性乳腺癌的风险在统计学上显著更高。