Center for Cancer Epidemiology and Prevention, Yale School of Public Health, Yale School of Medicine, New Haven, CT 06510, USA.
Cancer Epidemiol. 2012 Apr;36(2):161-8. doi: 10.1016/j.canep.2012.01.001. Epub 2012 Feb 6.
The relationship between hormone therapy (HT) and invasive breast cancer has been extensively investigated, but the relationship between HT and in situ breast cancer has received relatively little attention. We examined the relationship between HT and ductal carcinoma in situ (DCIS) among postmenopausal women who participated in a population-based case-control study in Connecticut, USA.
This analysis included 1179 post-menopausal women (603 controls and 576 cases), who comprised a subset of a population-based case-control study that included all incident cases of breast carcinoma in situ (BCIS) in Connecticut and frequency-matched controls by 5-year age intervals.
We found no association between DCIS and ever use of any HT (adjusted odds ratio (OR)=0.85, 95% confidence interval (CI): 0.65-1.11); of estrogen alone (adjusted OR=0.93; 95% CI: 0.68-1.29) or of estrogen and progesterone (adjusted OR=0.75; 95% CI: 0.52-1.08). There was also no association between DCIS and current use of these hormones. In addition, estimated risk of DCIS did not increase with duration of use of these preparations.
These results add to a small literature that remains inconclusive. To determine whether HT poses risk of in situ breast cancer, larger studies with greater power and precise control of important covariates (e.g., mammography screening) are needed, as are meta-analyses of available data.
激素疗法(HT)与浸润性乳腺癌之间的关系已得到广泛研究,但 HT 与原位乳腺癌之间的关系却受到较少关注。我们在美国康涅狄格州进行的一项基于人群的病例对照研究中,研究了接受 HT 的绝经后妇女与导管原位癌(DCIS)之间的关系。
该分析包括 1179 名绝经后妇女(603 名对照和 576 名病例),这些妇女是基于人群的病例对照研究的一部分,该研究包括康涅狄格州所有原位乳腺癌(BCIS)的所有发病病例和按 5 年年龄间隔匹配的频率对照。
我们发现 DCIS 与任何 HT 的使用无关(调整后的比值比(OR)=0.85,95%置信区间(CI):0.65-1.11);单独使用雌激素(调整后的 OR=0.93;95%CI:0.68-1.29)或雌激素和孕激素(调整后的 OR=0.75;95%CI:0.52-1.08)也是如此。这些激素的当前使用也与 DCIS 无关。此外,这些制剂使用时间长短与 DCIS 的估计风险无关。
这些结果增加了一些仍不确定的小型文献。为了确定 HT 是否会增加原位乳腺癌的风险,需要进行具有更大功率和对重要协变量(例如,乳房 X 线照相筛查)进行精确控制的大型研究,以及对现有数据进行荟萃分析。