Gompel Anne
Université Paris-Descartes, Gynécologie, 123, boulevard de Port-Royal, 75014 Paris, France.
Presse Med. 2019 Oct;48(10):1085-1091. doi: 10.1016/j.lpm.2019.09.021. Epub 2019 Oct 26.
Most of breast cancers are hormonedependent. Hormone treatment (contraception and menopause hormone treatment) has a promoter effect on preexisting lesions: the increase in risk decreases after stopping treatment. Hormonal contraception increases modestly the risk in current users but the amplitude of the risk remains low up to 40 years when this increase is more significant due of the number of breast cancer occurring at that age. Pregnancy decreases the risk if at a young age but after 25 years may increase the risk. Combined menopause hormone treatment is associated to a greater risk than estrogens alone. Breast cancer associated with hormone treatment is estradiol receptor positive. There is an increase in the risk with duration. Combining the hormone treatment with an anti-estrogen could decrease the risk of breast cancer and help to keep the benefits of estrogens.
大多数乳腺癌是激素依赖性的。激素治疗(避孕和绝经激素治疗)对已有的病变有促进作用:停止治疗后风险增加会降低。激素避孕会适度增加当前使用者的风险,但在40岁之前风险增幅仍然较低,因为该年龄段乳腺癌发生数量较多,所以此时风险增加更为显著。年轻时怀孕会降低风险,但25岁之后可能会增加风险。联合绝经激素治疗比单独使用雌激素的风险更高。与激素治疗相关的乳腺癌是雌激素受体阳性。风险会随着持续时间增加。将激素治疗与抗雌激素联合使用可以降低乳腺癌风险,并有助于保留雌激素的益处。