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Association of hormone replacement therapy to estrogen and progesterone receptor status in invasive breast carcinoma.

Abstract

BACKGROUND

Observational studies and randomized trials have demonstrated that hormone replacement therapy (HRT) increases the recipient's risk of developing breast carcinoma. Because it is known that some breast malignancies are hormonally responsive and that others are not, it has been hypothesized that HRT may be associated with the development of estrogen receptor (ER)-positive/progesterone receptor (PR)-positive breast carcinoma more so than with the development of ER-negative/PR-negative breast carcinoma.

METHODS

The Nurses' Health Study is a prospective cohort study that enrolled 121,700 female registered nurses ages 30-55 years in 1976. In the current study, the authors analyzed 2548 malignancies that developed among eligible postmenopausal women in that cohort between 1980 and 2000 and for which data on ER and PR status were available.

RESULTS

Compared with women who had never used HRT, current long-term users of HRT were more likely to develop ER-positive/PR-positive breast carcinoma (multivariate risk ratio [RR], 1.80; 95% confidence interval [CI], 1.52-2.12) but were not any more likely to develop ER-negative/PR-negative disease (multivariate RR, 1.00; 95% CI, 0.72-1.39). This effect grew stronger with increasing duration of current HRT use and was also more pronounced among women with body mass index < 25 kg/m2. Furthermore, the association between HRT use and ER-positive/PR-positive disease was stronger among patients receiving combined HRT (CHRT) regimens, which included estrogen and progesterone, than among users of estrogen alone (ERT). In addition, tumors tended to develop more quickly in current users of CHRT than in ERT users.

CONCLUSIONS

The finding that current users of HRT were more likely to develop ER-positive/PR-positive tumors than they were to develop ER-negative/PR-negative ones suggests that both endogenous and exogenous hormonal factors may influence breast tumor characteristics. In analyses of the effects of hormonal factors on breast tumor development, ER-positive/PR-positive tumors and ER-negative/PR-negative tumors should be considered separately from each other.

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  • Authors+Show Affiliations

    ,

    Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. wychen@partners.org

    , , , ,

    Source

    Cancer 101:7 2004 Oct 01 pg 1490-500

    MeSH

    Adult
    Breast Neoplasms
    Female
    Hormone Replacement Therapy
    Humans
    Middle Aged
    Multivariate Analysis
    Prospective Studies
    Receptors, Estrogen
    Receptors, Progesterone
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15378477

    Citation

    Chen, Wendy Y., et al. "Association of Hormone Replacement Therapy to Estrogen and Progesterone Receptor Status in Invasive Breast Carcinoma." Cancer, vol. 101, no. 7, 2004, pp. 1490-500.
    Chen WY, Hankinson SE, Schnitt SJ, et al. Association of hormone replacement therapy to estrogen and progesterone receptor status in invasive breast carcinoma. Cancer. 2004;101(7):1490-500.
    Chen, W. Y., Hankinson, S. E., Schnitt, S. J., Rosner, B. A., Holmes, M. D., & Colditz, G. A. (2004). Association of hormone replacement therapy to estrogen and progesterone receptor status in invasive breast carcinoma. Cancer, 101(7), pp. 1490-500.
    Chen WY, et al. Association of Hormone Replacement Therapy to Estrogen and Progesterone Receptor Status in Invasive Breast Carcinoma. Cancer. 2004 Oct 1;101(7):1490-500. PubMed PMID: 15378477.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association of hormone replacement therapy to estrogen and progesterone receptor status in invasive breast carcinoma. AU - Chen,Wendy Y, AU - Hankinson,Susan E, AU - Schnitt,Stuart J, AU - Rosner,Bernard A, AU - Holmes,Michelle D, AU - Colditz,Graham A, PY - 2004/9/21/pubmed PY - 2004/10/27/medline PY - 2004/9/21/entrez SP - 1490 EP - 500 JF - Cancer JO - Cancer VL - 101 IS - 7 N2 - BACKGROUND: Observational studies and randomized trials have demonstrated that hormone replacement therapy (HRT) increases the recipient's risk of developing breast carcinoma. Because it is known that some breast malignancies are hormonally responsive and that others are not, it has been hypothesized that HRT may be associated with the development of estrogen receptor (ER)-positive/progesterone receptor (PR)-positive breast carcinoma more so than with the development of ER-negative/PR-negative breast carcinoma. METHODS: The Nurses' Health Study is a prospective cohort study that enrolled 121,700 female registered nurses ages 30-55 years in 1976. In the current study, the authors analyzed 2548 malignancies that developed among eligible postmenopausal women in that cohort between 1980 and 2000 and for which data on ER and PR status were available. RESULTS: Compared with women who had never used HRT, current long-term users of HRT were more likely to develop ER-positive/PR-positive breast carcinoma (multivariate risk ratio [RR], 1.80; 95% confidence interval [CI], 1.52-2.12) but were not any more likely to develop ER-negative/PR-negative disease (multivariate RR, 1.00; 95% CI, 0.72-1.39). This effect grew stronger with increasing duration of current HRT use and was also more pronounced among women with body mass index < 25 kg/m2. Furthermore, the association between HRT use and ER-positive/PR-positive disease was stronger among patients receiving combined HRT (CHRT) regimens, which included estrogen and progesterone, than among users of estrogen alone (ERT). In addition, tumors tended to develop more quickly in current users of CHRT than in ERT users. CONCLUSIONS: The finding that current users of HRT were more likely to develop ER-positive/PR-positive tumors than they were to develop ER-negative/PR-negative ones suggests that both endogenous and exogenous hormonal factors may influence breast tumor characteristics. In analyses of the effects of hormonal factors on breast tumor development, ER-positive/PR-positive tumors and ER-negative/PR-negative tumors should be considered separately from each other. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/15378477/Association_of_hormone_replacement_therapy_to_estrogen_and_progesterone_receptor_status_in_invasive_breast_carcinoma_ L2 - https://doi.org/10.1002/cncr.20499 DB - PRIME DP - Unbound Medicine ER -