Tags

Type your tag names separated by a space and hit enter

Sex steroid hormones and breast cancer: is there a link with oral contraceptives and hormone replacement therapy?
Med J Aust. 1992 Jan 20; 156(2):124-32.MJ

Abstract

OBJECTIVE

To determine whether use of sex steroid hormones for contraception and hormone replacement therapy alters the risk of breast cancer, and whether the risk varies with their composition, duration of use, the period of a woman's life when the hormones are used, and after successful treatment for breast cancer.

DATA SOURCES

The results of important epidemiological reports, readily available from the English literature and published since 1981, were evaluated, using reports of basic scientific work as a background to the problem.

STUDY SELECTION

An attempt was made to obtain most of the relevant reports. Twenty case-control and seven cohort studies were available on the oral contraceptive pill (OCP) and eleven case-control and five cohort studies on hormone replacement therapy (HRT).

DATA EXTRACTION

The relative risk estimates for breast cancer (and their 95% confidence intervals) determined by each report were tabulated according to the specific conditions of analysis, for example users under age 25, duration of use. Results by meta-analysis from previous studies were also used to determine risk. A significant positive association was present when the risk estimate exceeded 1.0 and the 95% confidence interval did not cross 1.0.

DATA SYNTHESIS

Among OCP users, the vast majority of reports showed no significant risk of breast cancer--overall, longest duration of use, and use before first full-term pregnancy. However, a positive association between breast cancer and users under age 25 was found in three of eight reports. Similarly, the majority of reports showed no significant risk of breast cancer among HRT users, overall as well as in relation to duration of use and interval since first use. There was no increased risk with additional progestogen; it may be protective. An improved prognosis was found in users who developed breast cancer. On the limited data, use of hormones for postmenopausal symptoms did not appear to be harmful to women who had been successfully treated for breast cancer.

CONCLUSIONS

The review revealed good evidence that use of sex steroid hormones had no significant effect on the risk of breast cancer, whether given for contraception or hormone replacement. There was some concern about increased risk with prolonged use of the OCP, especially in younger women. At present, use of these hormones is a matter of informed choice, with individual considerations of the risk-benefit ratio.

Authors+Show Affiliations

Royal Brisbane Hospital, Herston, QLD.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1736053

Citation

Khoo, S K., and P Chick. "Sex Steroid Hormones and Breast Cancer: Is There a Link With Oral Contraceptives and Hormone Replacement Therapy?" The Medical Journal of Australia, vol. 156, no. 2, 1992, pp. 124-32.
Khoo SK, Chick P. Sex steroid hormones and breast cancer: is there a link with oral contraceptives and hormone replacement therapy? Med J Aust. 1992;156(2):124-32.
Khoo, S. K., & Chick, P. (1992). Sex steroid hormones and breast cancer: is there a link with oral contraceptives and hormone replacement therapy? The Medical Journal of Australia, 156(2), 124-32.
Khoo SK, Chick P. Sex Steroid Hormones and Breast Cancer: Is There a Link With Oral Contraceptives and Hormone Replacement Therapy. Med J Aust. 1992 Jan 20;156(2):124-32. PubMed PMID: 1736053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sex steroid hormones and breast cancer: is there a link with oral contraceptives and hormone replacement therapy? AU - Khoo,S K, AU - Chick,P, PY - 1992/1/20/pubmed PY - 1992/1/20/medline PY - 1992/1/20/entrez KW - Age Factors KW - Australia KW - Bias KW - Biology KW - Breast Cancer--etiology KW - Cancer KW - Case Control Studies KW - Cohort Analysis KW - Contraception KW - Contraceptive Methods KW - Data Analysis KW - Demographic Factors KW - Developed Countries KW - Diseases KW - Endocrine System KW - Epidemiologic Methods KW - Error Sources KW - Estrogens--administraction and dosage KW - Family Planning KW - Hormones KW - Incidence--changes KW - Literature Review KW - Mammary Gland Effects KW - Measurement KW - Mortality KW - Neoplasms KW - Oceania KW - Oral Contraceptives KW - Physiology KW - Population KW - Population Characteristics KW - Population Dynamics KW - Progestational Hormones KW - Progesterone--beneficial effects KW - Research Methodology KW - Research Report KW - Risk Factors KW - Studies KW - Time Factors SP - 124 EP - 32 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 156 IS - 2 N2 - OBJECTIVE: To determine whether use of sex steroid hormones for contraception and hormone replacement therapy alters the risk of breast cancer, and whether the risk varies with their composition, duration of use, the period of a woman's life when the hormones are used, and after successful treatment for breast cancer. DATA SOURCES: The results of important epidemiological reports, readily available from the English literature and published since 1981, were evaluated, using reports of basic scientific work as a background to the problem. STUDY SELECTION: An attempt was made to obtain most of the relevant reports. Twenty case-control and seven cohort studies were available on the oral contraceptive pill (OCP) and eleven case-control and five cohort studies on hormone replacement therapy (HRT). DATA EXTRACTION: The relative risk estimates for breast cancer (and their 95% confidence intervals) determined by each report were tabulated according to the specific conditions of analysis, for example users under age 25, duration of use. Results by meta-analysis from previous studies were also used to determine risk. A significant positive association was present when the risk estimate exceeded 1.0 and the 95% confidence interval did not cross 1.0. DATA SYNTHESIS: Among OCP users, the vast majority of reports showed no significant risk of breast cancer--overall, longest duration of use, and use before first full-term pregnancy. However, a positive association between breast cancer and users under age 25 was found in three of eight reports. Similarly, the majority of reports showed no significant risk of breast cancer among HRT users, overall as well as in relation to duration of use and interval since first use. There was no increased risk with additional progestogen; it may be protective. An improved prognosis was found in users who developed breast cancer. On the limited data, use of hormones for postmenopausal symptoms did not appear to be harmful to women who had been successfully treated for breast cancer. CONCLUSIONS: The review revealed good evidence that use of sex steroid hormones had no significant effect on the risk of breast cancer, whether given for contraception or hormone replacement. There was some concern about increased risk with prolonged use of the OCP, especially in younger women. At present, use of these hormones is a matter of informed choice, with individual considerations of the risk-benefit ratio. SN - 0025-729X UR - https://www.unboundmedicine.com/medline/citation/1736053/Sex_steroid_hormones_and_breast_cancer:_is_there_a_link_with_oral_contraceptives_and_hormone_replacement_therapy L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0025-729X&date=1992&volume=156&issue=2&spage=124 DB - PRIME DP - Unbound Medicine ER -