Use of Different Postmenopausal Hormone Therapies and Risk of Histology- and Hormone Receptor–Defined Invasive Breast Cancer

• Published in: Journal of clinical oncology Vol. 26; no. 8; pp. 1260 - 1268
• Main Authors: Fournier, Agnès, Fabre, Alban, Mesrine, Sylvie, Boutron-Ruault, Marie-Christine, Berrino, Franco, Clavel-Chapelon, Françoise
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 10.03.2008; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Biological and medical sciences; Breast Neoplasms - drug therapy; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Cancer; Carcinoma, Ductal, Breast - drug therapy; Carcinoma, Ductal, Breast - metabolism; Carcinoma, Ductal, Breast - pathology; Carcinoma, Lobular - drug therapy; Carcinoma, Lobular - metabolism; Carcinoma, Lobular - pathology; Cohort Studies; Dydrogesterone - therapeutic use; Estrogens - therapeutic use; Female; Gynecology and obstetrics; Gynecology. Andrology. Obstetrics; Human health and pathology; Humans; Life Sciences; Mammary gland diseases; Medical sciences; Middle Aged; Postmenopause; Progesterone - therapeutic use; Progestins - therapeutic use; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Risk Factors; Santé publique et épidémiologie; SEER Program; Tumors; Breast disease; Hormone therapy; Breast cancer; Histology; Malignant tumor; Infiltrating tumor; Epidemiology; Mammary gland diseases; Cancerology; Risk factor; Postmenopause; Invasive cancer; Cancer; Hormonal receptor
• ISSN: 0732-183X; 1527-7755; 1527-7755
• DOI: 10.1200/JCO.2007.13.4338

We previously found that the risk of invasive breast cancer varied according to the progestagen component of combined postmenopausal hormone therapy (CHT): progesterone, dydrogesterone, or other progestagens. We conducted the present study to assess how these CHTs were associated with histology- and hormone receptor-defined breast cancer. We used data from the French E3N cohort study, with 80,391 postmenopausal women followed for a mean duration of 8.1 years; 2,265 histologically confirmed invasive breast cancers were identified through biennial self-administered questionnaires completed from 1990 to 2002. The relative risks (RRs) were estimated using Cox proportional hazards models. Compared with postmenopausal hormone therapy (HT) never-use, ever-use of estrogen+progesterone was not significantly associated with the risk of any breast cancer subtype, but increasing duration of estrogen+progesterone was associated with increasing risks of lobular (P = .06) and estrogen receptor-positive/progesterone receptor-negative (ER+/PR-; P = .02). Estrogen+dydrogesterone was associated with a significant increase in risk of lobular carcinoma (RR, 1.7; 95% CI, 1.1 to 2.6). Estrogen+other progestagens was associated with significant increases in risk of ductal and lobular carcinomas (RR, 1.6; 95% CI, 1.3 to 1.8; and 2.0; 95% CI, 1.5 to 2.7, respectively), of ER+/PR+ and ER+/PR- carcinomas (RR, 1.8; 95% CI, 1.5 to 2.1; and 2.6; 95% CI, 1.9 to 3.5, respectively), but not of ER-/PR+ or ER-/PR- carcinomas (RR, 1.0; 95% CI, 0.5 to 2.1; and 1.4; 95% CI, 0.9 to 2.0, respectively). The increase in risk of breast cancer observed with the use of CHTs other than estrogen+progesterone and estrogen+dydrogesterone seems to apply preferentially to ER+ carcinomas, especially those ER+/PR-, and to affect both ductal and lobular carcinomas.