© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 10, 754-761,
May 16, 2001
© 2001 Oxford University Press
REPORT |
Hormone Replacement Therapy After a Diagnosis of Breast Cancer in Relation to Recurrence and Mortality
Affiliations of authors: E. S. O'Meara, M. A. Rossing, J. R. Daling, N. S. Weiss, Fred Hutchinson Cancer Research Center and Department of Epidemiology, University of Washington, Seattle; J. G. Elmore, Departments of Epidemiology and General Internal Medicine, University of Washington, and Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle; W. E. Barlow, Department of Biostatistics, University of Washington, and Center for Health Studies, Group Health Cooperative of Puget Sound.
Correspondence to: Ellen S. O'Meara, Ph.D., Cardiovascular Health Study, University of Washington, 600 Stewart St., Suite 700, Seattle, WA 98101 (e-mail: eomeara{at}u.washington.edu).
Background: Hormone replacement therapy (HRT) is typically avoided for women with a history of breast cancer because of concerns that estrogen will stimulate recurrence. In this study, we sought to evaluate the impact of HRT on recurrence and mortality after a diagnosis of breast cancer. Methods: Data were assembled from 2755 women aged 35–74 years who were diagnosed with incident invasive breast cancer while they were enrolled in a large health maintenance organization from 1977 through 1994. Pharmacy data identified 174 users of HRT after diagnosis. Each HRT user was matched to four randomly selected nonusers of HRT with similar age, disease stage, and year of diagnosis. Women in the analysis were recurrence free at HRT initiation or the equivalent time since diagnosis. Rates of recurrence and death through 1996 were calculated. Adjusted relative risks were estimated by use of the Cox regression model. All statistical tests were two-sided. Results: The rate of breast cancer recurrence was 17 per 1000 person-years in women who used HRT after diagnosis and 30 per 1000 person-years in nonusers (adjusted relative risk for users compared with nonusers = 0.50; 95% confidence interval [CI] = 0.30 to 0.85). Breast cancer mortality rates were five per 1000 person-years in HRT users and 15 per 1000 person-years in nonusers (adjusted relative risk = 0.34; 95% CI = 0.13 to 0.91). Total mortality rates were 16 per 1000 person-years in HRT users and 30 per 1000 person-years in nonusers (adjusted relative risk = 0.48; 95% CI = 0.29 to 0.78). The relatively low rates of recurrence and death were observed in women who used any type of HRT (oral only = 41% of HRT users; vaginal only = 43%; both oral and vaginal = 16%). No trend toward lower relative risks was observed with increased dose. Conclusion: We observed lower risks of recurrence and mortality in women who used HRT after breast cancer diagnosis than in women who did not. Although residual confounding may exist, the results suggest that HRT after breast cancer has no adverse impact on recurrence and mortality.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. Holmberg, O.-E. Iversen, C. M. Rudenstam, M. Hammar, E. Kumpulainen, J. Jaskiewicz, J. Jassem, D. Dobaczewska, H. E. Fjosne, O. Peralta, et al. Increased Risk of Recurrence After Hormone Replacement Therapy in Breast Cancer Survivors J Natl Cancer Inst, April 2, 2008; 100(7): 475 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Newcomb, K. M. Egan, A. Trentham-Dietz, L. Titus-Ernstoff, J. A. Baron, J. M. Hampton, M. J. Stampfer, and W. C. Willett Prediagnostic Use of Hormone Therapy and Mortality After Breast Cancer Cancer Epidemiol. Biomarkers Prev., April 1, 2008; 17(4): 864 - 871. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. C. Figueiredo, L. Bernstein, M. Capanu, K. E. Malone, C. F. Lynch, H. Anton-Culver, M. Stovall, L. Bertelsen, R. W. Haile, and J. L. Bernstein Oral Contraceptives, Postmenopausal Hormones, and Risk of Asynchronous Bilateral Breast Cancer: The WECARE Study Group J. Clin. Oncol., March 20, 2008; 26(9): 1411 - 1418. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Antoine, F. Liebens, B. Carly, A. Pastijn, S. Neusy, and S. Rozenberg Safety of hormone therapy after breast cancer: a qualitative systematic review Hum. Reprod., February 1, 2007; 22(2): 616 - 622. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Banks and G. Reeves Pregnancy in women with a history of breast cancer BMJ, January 27, 2007; 334(7586): 166 - 167. [Full Text] [PDF]
|
|
|
|
 |
|
 L. B. Michaud and S. Goodin Cancer-treatment-induced bone loss, part 2 Am. J. Health Syst. Pharm., March 15, 2006; 63(6): 534 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Chlebowski and G. L. Anderson Progestins and Recurrence in Breast Cancer Survivors J Natl Cancer Inst, April 6, 2005; 97(7): 471 - 472. [Full Text] [PDF]
|
|
|
|
 |
|
 N Angelopoulos, V Barbounis, S Livadas, D Kaltsas, and G Tolis Effects of estrogen deprivation due to breast cancer treatment Endocr. Relat. Cancer, September 1, 2004; 11(3): 523 - 535. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. E. Smith and M. Dowsett Aromatase Inhibitors in Breast Cancer N. Engl. J. Med., June 12, 2003; 348(24): 2431 - 2442. [Full Text] [PDF]
|
|
|
|
 |
|
 T. D. Shanafelt, D. L. Barton, A. A. Adjei, and C. L. Loprinzi Pathophysiology and Treatment of Hot Flashes Mayo Clin. Proc., November 1, 2002; 77(11): 1207 - 1218. [Abstract] [PDF]
|
|
|
|
 |
|
 J. Cheek, J. Lacy, S. Toth-Fejel, K. Morris, K. Calhoun, and R. F. Pommier The Impact of Hormone Replacement Therapy on the Detection and Stage of Breast Cancer Arch Surg, September 1, 2002; 137(9): 1015 - 1021. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. I. Pritchard, H. Khan, and M. Levine Clinical practice guidelines for the care and treatment of breast cancer: 14. The role of hormone replacement therapy in women with a previous diagnosis of breast cancer Can. Med. Assoc. J., April 1, 2002; 166(8): 1017 - 1022. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. G. Vogel Why Do We Still Use Hormone Replacement Therapy? Why Don't We Use It More? J. Clin. Oncol., February 1, 2002; 20(3): 616 - 619. [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Messina and C. L. Loprinzi Soy for Breast Cancer Survivors: A Critical Review of the Literature J. Nutr., November 1, 2001; 131(11): 3095S - 3108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Hormone Therapy After Breast Cancer Journal Watch Women's Health, August 1, 2001; 2001(801): 1 - 1. [Full Text]
|
|
|
|
 |
|
 Is Hormone Replacement Therapy Safe After Breast Cancer? Journal Watch Gastroenterology, July 18, 2001; 2001(718): 12 - 12. [Full Text]
|
|
|
|
 |
|
 Is Hormone Replacement Therapy Safe After Breast Cancer? Journal Watch (General), June 8, 2001; 2001(608): 1 - 1. [Full Text]
|
|
|
|
|
|
J. Cuzick Is Hormone Replacement Therapy Safe for Breast Cancer Patients? J Natl Cancer Inst, May 16, 2001; 93(10): 733 - 733. [Full Text] [PDF]
|
|