Bland K I, Buchanan J B, Weisberg B F, Hagan T A, Gray L A
Cancer. 1980 Jun 15;45(12):3027-33. doi: 10.1002/1097-0142(19800615)45:12<3027::aid-cncr2820451225>3.0.co;2-2.
A retrospective pilot study was implemented to better define the potential carcinogenic role of conjugated equine estrogen (Premarin) on the breast, and the influence of these hormone analogues on proliferative and atrophic breast parenchyma as determined by high-quality serial xeromammograms. Four hundred and five postmenopausal (spontaneous and surgical) women (mean age 59.7 years) were group matched for the risk factors of age and parity. The dominant parenchymal pattern (N1P1P2DY) as disclosed mammographically was determined for each patient, who was then categorized into one of four groups: Group 1 Asymptomatic-no hormones, 124 patients; Group 2 Symptomatic-no hormones, 75 patients; Group 3 Asymptomatic-hormones; 152 patients; and Group 4 Symptomatic-hormones, 54 patients. Patients in Groups 3 and 4 were treated with therapeutic estrogens a minimum of 18 months (mean 79 months) and follow-up ranged from 39-344 months. In the entire series, 25 carcinomas (6.2%) were detected. In Group 3, five carcinomas (2.4%) were detected, but two cancers (1.0%) were found in symptomatic estrogen users. The occurrence of carcinoma in Group 2 was greater than the remaining categories; however, cancer risk was not statistically greater in any category with regard to hormone replacement therapy. Patients treated with therapeutic estrogens were observed to have an increase of 8.9% in the frequency of a more glandular (P2,DY) mammographic parenchymal pattern and this was noted to be within the range of interpretation error of the mammographer. This suggests a physiologic effect of therapeutic estrogens on atrophic breast parenchyma with conversion to a glandular, proliferative state. This study suggests that long-term replacement estrogen therapy for postmenopausal symptoms does not significantly alter mammographic parenchymal patterns and that the use of these compounds in therapeutic doses does not increase the risk of breast cancer.
开展了一项回顾性试点研究，以更好地确定共轭马雌激素（倍美力）对乳腺的潜在致癌作用，以及这些激素类似物对通过高质量乳腺干板X线照片确定的增生性和萎缩性乳腺实质的影响。405名绝经后（自然绝经和手术绝经）女性（平均年龄59.7岁）根据年龄和生育情况等风险因素进行分组匹配。为每位患者确定乳腺X线检查显示的主要实质模式（N1P1P2DY），然后将其分为四组之一：第1组无症状-未使用激素，124例患者；第2组有症状-未使用激素，75例患者；第3组无症状-使用激素，152例患者；第4组有症状-使用激素，54例患者。第3组和第4组患者接受治疗性雌激素治疗至少18个月（平均79个月），随访时间为39 - 344个月。在整个系列中，检测到25例癌症（6.2%）。在第3组中，检测到5例癌症（2.4%），但在有症状的雌激素使用者中发现2例癌症（1.0%）。第2组癌症的发生率高于其他类别；然而，就激素替代疗法而言，任何类别中的癌症风险在统计学上均无显著增加。观察到接受治疗性雌激素治疗的患者乳腺X线实质模式中更具腺性（P2，DY）的频率增加了8.9%，并且这被认为在乳腺X线检查人员的解释误差范围内。这表明治疗性雌激素对萎缩性乳腺实质有生理作用，使其转变为腺性、增生状态。这项研究表明，针对绝经后症状的长期替代雌激素治疗不会显著改变乳腺X线实质模式，并且以治疗剂量使用这些化合物不会增加患乳腺癌的风险。
