Czernichow Camille, This Pascale, Asselain Bernard, Falcou Marie-Christine, Savignoni Alexia, Salmon Rémy J, Sigal-Zafrani B
Département de chirurgie, Institut Curie, 26, rue d'Ulm,75005 Paris.
Bull Cancer. 2007 May;94(5):469-75.
Several recent papers have suggested the role of HRT in the development of breast cancers. From the data base of the Institut Curie we compared the clinical characteristics, histoprognosis factors and survival of a cohort of 6737 patients recorded between 1988 and 1999 in which 1482 declared having receive HRT for more than 6 months. Surgical procedure, locoregional recurrence, metastasis, disease free and global survival were compared bet the patient who received an HRT versus the patients who didn't receive this treatment Mammographic diagnosis was more frequent in the HRT group and the age at diagnosis was smaller (p < 10(-4)). Cancers diagnosed in the HRT group were smaller and had a more favourable biologic profile as well as there were more lobular carcinomas and the conservative treatment was more frequent (p < 10(-4)). Mean follow up was 97 months. Recurrence free survival was not different in the two groups but the metastasis free and global survival were better in the HRT group. HRT remained an independent prognostic factor in a multivariate analysis. In western countries the increasing incidence of breast cancer concerns pre as well as post menopausal women. HRT cannot be considered as the only responsible of this augmentation.
最近的几篇论文提出了激素替代疗法(HRT)在乳腺癌发生中的作用。我们从居里研究所的数据库中,比较了1988年至1999年间记录的6737名患者的临床特征、组织预后因素和生存率,其中1482名患者宣称接受HRT超过6个月。比较了接受HRT的患者与未接受该治疗的患者的手术程序、局部区域复发、转移、无病生存率和总生存率。HRT组的乳房X线诊断更为频繁,诊断时的年龄更小(p < 10⁻⁴)。HRT组诊断出的癌症更小,生物学特征更有利,小叶癌更多,保守治疗更频繁(p < 10⁻⁴)。平均随访时间为97个月。两组的无复发生存率没有差异,但HRT组的无转移生存率和总生存率更好。在多变量分析中,HRT仍然是一个独立的预后因素。在西方国家,乳腺癌发病率的上升涉及绝经前和绝经后女性。不能认为HRT是这种增加的唯一原因。