Rohan T E, McMichael A J
CSIRO Division of Human Nutrition, Adelaide, SA.
Med J Aust. 1988 Mar 7;148(5):217-21. doi: 10.5694/j.1326-5377.1988.tb99427.x.
Previous evidence of an increased risk of breast cancer in association with the use of non-contraceptive exogenous oestrogen therapy has not been consistent. In this population-based case-control study of breast cancer (comprising 451 case-control pairs in all) the relationship between the use of non-contraceptive exogenous oestrogen therapy and the risk of breast cancer was examined in the 281 case subjects and 288 control subjects (262 case-control pairs) who were postmenopausal, since the major reported indication for the use of exogenous oestrogen therapy is for the relief of menopausal symptoms. "Ever use" of exogenous oestrogen therapy was associated with an adjusted relative risk of 1.03 (95% confidence interval, 0.62-1.69). The risk of breast cancer was not associated with the duration of use, years since first use, or years since last use of exogenous oestrogen therapy. Stratified analyses of breast cancer showed a 35% increase in risk in nulliparous women that is associated with the use of exogenous oestrogen therapy, a 40% reduction in risk in women with a history of benign breast disease (both statistically not significant), and a statistically significant 70% reduction in risk in women with a history of bilateral oophorectomy. The results of this study should be weighed against those of several earlier studies which suggest caution in the prescription of replacement oestrogen therapy for those women who are known already to be at an increased risk of breast cancer.
先前有关使用非避孕外源性雌激素疗法会增加患乳腺癌风险的证据并不一致。在这项基于人群的乳腺癌病例对照研究（总共包括451对病例对照）中，对281例病例受试者和288例对照受试者（262对病例对照）进行了研究，这些受试者均已绝经，因为据报道外源性雌激素疗法的主要适应症是缓解更年期症状。外源性雌激素疗法的“曾经使用”与调整后的相对风险1.03相关（95%置信区间，0.62 - 1.69）。乳腺癌风险与外源性雌激素疗法的使用时长、首次使用后的年数或末次使用后的年数均无关。对乳腺癌的分层分析显示，未生育女性使用外源性雌激素疗法后风险增加35%，有良性乳腺疾病史的女性风险降低40%（两者在统计学上均无显著意义），而有双侧卵巢切除术史的女性风险在统计学上显著降低70%。本研究结果应与之前的几项研究结果综合考量，之前的研究表明，对于已知患乳腺癌风险增加的女性，在开具替代雌激素疗法处方时应谨慎。
