Gertig Dorota M, Fletcher Ashley S, English Dallas R, Macinnis Robert J, Hopper John L, Giles Graham G
Centre for Genetic Epidemiology, University of Melbourne, Melbourne Victoria, Australia.
Menopause. 2006 Mar-Apr;13(2):178-84. doi: 10.1097/01.gme.0000177317.85887.65.
To determine factors that may modify the association between hormone therapy (HT) and breast cancer risk.
Prospective cohort study (the Melbourne Collaborative Cohort Study) of 24,479 women aged 40 to 69 years. History of HT use was collected at baseline and 4 years later by questionnaire. By June 2002, 336 cases of breast cancer were diagnosed among 13,444 women postmenopausal at baseline. Association of breast cancer risk with history of HT use was analyzed using proportional hazards models.
The hazard ratio (HR) for recent HT use (current or stopped within the last year) was elevated (HR 1.51; 95% CI, 1.16-1.98) but was not significantly increased for past HT users (HR 1.19; 95% CI, 0.86-1.64). Recent HT use was associated with better differentiated tumors but was not more likely to be associated with estrogen receptor-positive / progesterone receptor-positive tumors. There was little evidence of interactions between recent HT use and body mass index, alcohol intake, parity, and smoking, although the HR for recent HT use in categories of alcohol consumption was greatest in women consuming the most alcohol (HR 2.37; 95% CI, 1.45-3.88 for those consuming > or = 10 g/d versus HR 1.33; 95% CI, 0.85-2.08 for nondrinkers, P interaction = 0.32).
The risk of breast cancer for recent users of HT in this Australian population is increased by approximately 50%. Our results suggest that any potential modifying effect of the association between HT and breast cancer risk by factors such as alcohol intake and body mass index is likely to be modest.
确定可能改变激素疗法（HT）与乳腺癌风险之间关联的因素。
对24479名年龄在40至69岁之间的女性进行的前瞻性队列研究（墨尔本协作队列研究）。通过问卷调查在基线时和4年后收集HT使用史。到2002年6月，在基线时绝经的13444名女性中诊断出336例乳腺癌。使用比例风险模型分析乳腺癌风险与HT使用史之间的关联。
近期使用HT（当前使用或在过去一年内停止使用）的风险比（HR）升高（HR 1.51；95%CI，1.16 - 1.98），但过去使用HT的人群中风险并未显著增加（HR 1.19；95%CI，0.86 - 1.64）。近期使用HT与分化较好的肿瘤相关，但与雌激素受体阳性/孕激素受体阳性肿瘤的关联可能性并未增加。几乎没有证据表明近期使用HT与体重指数、饮酒量、产次和吸烟之间存在相互作用，尽管在饮酒类别中，近期使用HT的HR在饮酒最多的女性中最高（饮酒量≥10克/天者的HR为2.37；95%CI，1.45 - 3.88，而不饮酒者的HR为1.33；95%CI，0.85 - 2.08，P相互作用 = 0.32）。
在这个澳大利亚人群中，近期使用HT的女性患乳腺癌的风险增加了约50%。我们的结果表明，诸如饮酒量和体重指数等因素对HT与乳腺癌风险之间关联的任何潜在改变作用可能较小。
