ReviewHormone replacement therapy and breast cancer: a qualitative review1☆,
Section snippets
Methods
We identified a list of publications of observational epidemiologic studies that included original data on ERT and breast cancer risk, HRT and breast cancer risk, and hormone therapy and breast cancer mortality.
Data sources
The keywords “estrogen,” “estrogen replacement therapy” or “hormone replacement therapy,” and “breast cancer” or “breast neoplasm,” were used to search for articles published from 1975–2000 in MEDLINE and Dialogweb. Each coauthor performed searches using several combination terms, such as “estrogen plus breast cancer and/or breast neoplasm,” “estrogen replacement therapy plus breast cancer and/or breast neoplasm,” “hormone replacement therapy plus breast cancer and/or breast neoplasm.”
Results
We identified 45 publications that assessed the association between ERT and breast cancer risk (Figure 1). 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65 Twenty studies assessed the association between HRT and breast cancer risk (Figure 2), 31, 40, 44, 45, 47, 51, 53, 54, 55, 56, 57, 60, 61, 63, 64, 65, 66, 67, 68, 69 five assessed the risk of hormone therapy and
Conclusion
Over 25 years ago, epidemiologic studies showed that ERT was associated with an increased risk of endometrial cancer, and that association was consistent among studies, relatively strong, and increased with increasing duration of use. In contrast, the relatively large body of literature on the association between estrogen and breast cancer is inconsistent, and the distribution of risk estimates is what would be expected if there were no association. That is, most of the estimates of risk
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Cited by (0)
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This work was supported by grants from the Department of Defense (# DAMD 17-00-0321 to Trudy Bush and Jodi Flaws) and Wyeth-Ayerst Laboratories (Trudy Bush).
Dr. Bush received honoraria from Wyeth-Ayerst Laboratories for speaking on this topic.
- 1
We thank Karen Mittleman, Laura Hirshfield, and Lynn Van Ruiten for their assistance.
- 2
Dr. Bush is deceased (March 14, 2001).