Habel Laurel A, Pressman Alice, Ettinger Bruce, Sidney Stephen, Suh-Burgmann Betty, Fehrenbacher Louis, Quesenberry Charles P
Division of Research, Kaiser Permanente, Oakland, CA 94612, USA.
Breast Cancer Res Treat. 2006 Mar;96(2):123-9. doi: 10.1007/s10549-005-9069-8.
To examine raloxifene use among women with a history of breast cancer.
Kaiser Permanente tumor registry and membership files were used to identify women diagnosed with breast cancer after 1994 who were health plan members in 1998 or later, when raloxifene became available. Information on raloxifene treatment was obtained from computerized pharmacy records. Treatment patterns were examined and the characteristics of those who did and did not receive raloxifene were compared.
Among the 17,968 women with a history of breast cancer, 711 (4.0%) had at least one prescription for raloxifene. Use among these women was more common than among similarly aged women in the health plan without a history of breast cancer, especially among those less than age 60 years. Among women with a history of breast cancer, raloxifene users were more than twice as likely as non-users to have had a bone mineral density test (60 versus 26%, p<0.0001) and, if tested, were more likely to have osteopenia or osteoporosis (80 versus 63%, p<0.0001). Compared to non-users, users had earlier stage breast cancer at diagnosis (80% versus 71% with local disease, p<0.0001). Raloxifene use was largely restricted to women whose initial breast cancer had not been treated with adjuvant tamoxifen or who had received less than 5 years of tamoxifen therapy.
In this setting, raloxifene use among women with a history of breast cancer is related to stage at diagnosis and bone mineral density and is rare among women who have completed a 5-year course of adjuvant tamoxifen.
研究有乳腺癌病史的女性使用雷洛昔芬的情况。
利用凯撒医疗机构肿瘤登记处和会员档案，识别出1994年后被诊断为乳腺癌且在1998年或之后（雷洛昔芬上市之时）成为健康计划会员的女性。雷洛昔芬治疗信息来自计算机化药房记录。研究治疗模式，并比较接受和未接受雷洛昔芬治疗的女性的特征。
在17968名有乳腺癌病史的女性中，711名（4.0%）至少有一张雷洛昔芬处方。这些女性中的使用情况比健康计划中无乳腺癌病史的同龄女性更为普遍，尤其是在60岁以下的女性中。在有乳腺癌病史的女性中，使用雷洛昔芬的女性进行骨密度检测的可能性是非使用者的两倍多（60%对26%，p<0.0001），并且如果进行了检测，更有可能患有骨质减少或骨质疏松（80%对63%，p<0.0001）。与非使用者相比，使用者在诊断时乳腺癌分期更早（局部疾病患者中80%对71%，p<0.0001）。雷洛昔芬的使用主要限于初始乳腺癌未接受辅助他莫昔芬治疗或接受他莫昔芬治疗少于5年的女性。
在这种情况下，有乳腺癌病史的女性使用雷洛昔芬与诊断时的分期和骨密度有关，在完成5年辅助他莫昔芬疗程的女性中很少见。
