Pocobelli Gaia, Newcomb Polly A, Li Christopher I, Cook Linda S, Barlow William E, Weiss Noel S
Department of Epidemiology, University of Washington, Seattle, WA, USA,
Breast Cancer Res Treat. 2014 Jun;145(2):439-47. doi: 10.1007/s10549-014-2911-0. Epub 2014 Mar 27.
Use of combined hormone therapy (CHT) is associated with increased breast cancer incidence, but it is unclear whether this translates into increased breast cancer mortality. To address this question, we conducted a population-based nested case-control study in Saskatchewan, Canada, where a population-based prescription drug database has existed since 1975. We evaluated fatal breast cancer risk in relation to recency and duration of use of CHT and unopposed estrogen hormone therapy (EHT). A total of 1,288 cases and 12,535 controls were included in the analyses. Exclusive use of EHT was not associated with fatal breast cancer risk, either overall or within categories of recency or duration [odds ratio (OR) for current vs. never use = 1.1; 95 % confidence interval (CI) 0.8-1.3]. Use of CHT (includes women who had also used EHT) was also not associated with fatal breast cancer risk (OR for current vs. never use = 0.9; 95 % CI 0.7-1.3), except for a suggestion of an increased risk with current long-term use. Consistent with prior studies, we observed no increased risk of fatal breast cancer associated with use of EHT. To date only a few studies have evaluated fatal breast cancer risk in relation to use of CHT, and collectively the results are inconsistent.
联合激素疗法（CHT）的使用与乳腺癌发病率增加相关，但尚不清楚这是否会转化为乳腺癌死亡率的增加。为解决这个问题，我们在加拿大萨斯喀彻温省开展了一项基于人群的巢式病例对照研究，该省自1975年起就有一个基于人群的处方药数据库。我们评估了与CHT及单纯雌激素激素疗法（EHT）近期使用情况和使用时长相关的致命性乳腺癌风险。分析共纳入了1288例病例和12535例对照。单纯使用EHT与致命性乳腺癌风险无关，无论是总体情况还是在近期使用情况或使用时长类别内均如此[当前使用者与从未使用者的比值比（OR）=1.1；95%置信区间（CI）0.8 - 1.3]。使用CHT（包括也使用过EHT的女性）也与致命性乳腺癌风险无关（当前使用者与从未使用者的OR = 0.9；95% CI 0.7 - 1.3），但当前长期使用者有风险增加的迹象。与先前研究一致，我们观察到使用EHT与致命性乳腺癌风险增加无关。迄今为止，仅有少数研究评估了与使用CHT相关的致命性乳腺癌风险，总体结果并不一致。
