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Hormone therapy and fatal breast cancer
Author(s) -
Norman Sandra A.,
Weber Anita L.,
Localio A. Russell,
Marchbanks Polly A.,
Ursin Giske,
Strom Brian L.,
Weiss Linda K.,
Burkman Ronald T.,
Bernstein Leslie,
Deapen Dennis M.,
Folger Suzanne G.,
Simon Michael S.,
Nadel Marion R.
Publication year - 2010
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1941
Subject(s) - medicine , breast cancer , hormone therapy , pharmacoepidemiology , oncology , hormone , cancer , pharmacology , medical prescription
Purpose Among unanswered questions is whether menopausal use of estrogen therapy (ET) or estrogen‐plus‐progestin therapy (CHT) increases risk of developing fatal breast cancer i.e., developing and dying of breast cancer. Using a population‐based case‐control design, we estimated incidence rate ratios of fatal breast cancer in postmenopausal hormone therapy (HT) users compared to non‐users by type, duration, and recency of HT use. Methods HT use prior to breast cancer diagnosis in 278 women who died of breast cancer within 6 years of diagnosis (cases) was compared with use in 2224 controls never diagnosed with breast cancer using conditional logistic regression. Measures taken to address potential bias and confounding inherent in case‐control studies included collecting and adjusting for detailed data on demographic and other factors potentially associated both with HT use and breast cancer. Results Fifty‐six per cent of cases and 68% of controls reported HT use. Among current 3+ year HT users, odds ratios and 95% confidence intervals for death were 0.83 (0.50, 1.38) and 0.69 (0.44, 1.09), respectively, for exclusive use of CHT or of ET, and were 0.94 (0.59, 1.48) and 0.70 (0.45, 1.07) for any use of CHT or of ET regardless of other hormone use. Conclusion Point estimates suggest no increased risk of fatal breast cancer with HT use, although 50% increases in risk in longer‐term current CHT users cannot be ruled out. Copyright © 2010 John Wiley & Sons, Ltd.