ホルモン補充療法と乳癌
閉経後の平均余命が30年近くもある日本人女性が健康な生活を維持するためには, 適切な医療とともにホルモン補充療法 (HRT : Hormone Replacement Therapy) を中心とした予防医学的管理が必要である。しかしながら, エストロゲンを中心とした薬物の長期投与によって発症するとされている子宮内膜癌や乳癌に対する認識不足のために, 対象者の1%のみがHRTを施行されているのがわが国の現状である。したがって, 本稿ではHRTの臨床的意義, 性ステロイドホルモン投与も含めた内分泌環境変化による乳腺組織の変化とともに, 乳癌発症との関連性について述べる。...
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| Published in | 日本乳癌検診学会誌 Vol. 7; no. 3; pp. 237 - 246 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本乳癌検診学会
20.10.1998
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0918-0729 1882-6873 |
| DOI | 10.3804/jjabcs.7.237 |
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| Abstract | 閉経後の平均余命が30年近くもある日本人女性が健康な生活を維持するためには, 適切な医療とともにホルモン補充療法 (HRT : Hormone Replacement Therapy) を中心とした予防医学的管理が必要である。しかしながら, エストロゲンを中心とした薬物の長期投与によって発症するとされている子宮内膜癌や乳癌に対する認識不足のために, 対象者の1%のみがHRTを施行されているのがわが国の現状である。したがって, 本稿ではHRTの臨床的意義, 性ステロイドホルモン投与も含めた内分泌環境変化による乳腺組織の変化とともに, 乳癌発症との関連性について述べる。 |
|---|---|
| AbstractList | 閉経後の平均余命が30年近くもある日本人女性が健康な生活を維持するためには, 適切な医療とともにホルモン補充療法 (HRT : Hormone Replacement Therapy) を中心とした予防医学的管理が必要である。しかしながら, エストロゲンを中心とした薬物の長期投与によって発症するとされている子宮内膜癌や乳癌に対する認識不足のために, 対象者の1%のみがHRTを施行されているのがわが国の現状である。したがって, 本稿ではHRTの臨床的意義, 性ステロイドホルモン投与も含めた内分泌環境変化による乳腺組織の変化とともに, 乳癌発症との関連性について述べる。 |
| Author | 土橋, 一慶 |
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| References | 9) Grodstein F, Stampfer MJ, Colditz GA, Willett WC, Manson JE, Joffe M, Rosner B, Fuchs C, Hankinson S, Hunter DJ, Hennekens CH, Speizer FE : Postmenopausal hormone therapy and mortality. N Engl J Med, 336 : 1769-1775, 1997 6) Jick SS, Walker AM, Jick H : Estrogens, progesterone, and endometrial cancer. Epidemiology, 4 : 20-24, 1993 16) Longacre TA, Bartow SA : A correlative morphologic study of human breast and endometrium in the menstrual cycle. Am J Surg Pathol, 10 : 382-393, 1986 15) Daly E, Vessey MP, Hawkins MM, Carson JL, Gough P, Marsh S : Risk of venous thromboembolism in users of hormone replacement therapy. Lancet, 348 : 977-980, 1996 22) Colditz GA, Hankinson SE, Hunter DJ, Willett WC, Manson JE, Stampfer MJ, Hennekens C, Rosner B, Speizner FE : The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. N Engl J Med, 332 : 1589-1593, 1995 4) 研修ノート;産婦人科外来の薬物療法;日本母性産婦人科医会編;50, 平成6年10月, 103-105 5) The Writing Group for the PEPI Trial : Effects of hormone replacement therapy on endometrial histology in postmenopausal women. JAMA, 275 : 370-375, 1996 1) Collaborative Group on Hormonal Factors in Breast Cancer (Beral V, et al) : Breast cancer and hormone replacement therapy : collaborative reanalysis of data from 51 epidemiological studies of 52705 women with breast cancer and 108411 women without breast cancer. Lancet, 350 : 1047-1059, 1997 7) The Writing Group for the PEPI Trial : Effects of estrogen or estrogen/progestagen regimens on heart disease risk factors in postmenopausal women. The Postmenopausal Estrogen/Progestagen Trial. JAMA, 273 : 199-208, 1995 3) Breckwoldt M, Keck C, Karck U : Benefits and risks of hormone replacement therapy (HRT).J Steroid Biochem Molec Biol, 53 : 205-208, 1995 14) Bilezekian JP : Major issues regarding estrogen replacement therapy in postmenopausal women. J Women Health, 3 : 273-282, 1994 17) Ferguson DJP, Anderson TJ : Morphological evaluation of cell turnover in relation to the menstrual cycle in the “resting” human breast. Br J Cancer, 44 : 177-181, 1981 21) Mills PK, Beeson WL, Phillips RL, Fraser GE : Prospective study of exogenous hormone use and breast cancer in Seventh-Day Adventists. Cancer, 64 : 591-597, 1989 23) Tavani A, Braga C, Vecchia CL, Negri E, Franceschi S : Hormone replacement treatment and breast cancer risk : An age-specific analysis. Cancer Epidem, Biomarkers & Prevention, 6 : 11-14, 1997 18) Key TJA, Pike MC : The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer. Eur J Cancer Clin Oncol, 24 : 29-43, 1988 11) Gould E, Woolley CS, Frankfurt M, McEwen BS : Gonadal steroids regulate dendritic spine density in hippocampal pyramidal cells in adulthood. J Neurosci, 46 : 1286-1291, 1990 20) 坂元吾偉 : 悪性疾患の病理学的解釈.産婦人科の世界, 49 : 22-30, 1997 13) Kawaa C, Resnick S, Morrison A, Broolmeyer R, Corrada M, Zonderman A, Bacal C, Lingle DD, Metter E : A prospective study of estrogen replacement therapy and the risk of developing Alzheimer's disease. The Baltimore Longitudinal Study of Aging. Am Acad Neurology, 48 : 1517-1521, 1997 24) Draper MW, Flowers DE, Huster WJ, Neild JA, Harper KD, Arnaud C : A controlled trial of raloxifene (LY 139481) HC1 : impact on bone turnover and serum lipid profile in healthy postmenopausal women. J Bone Miner Res, 11 : 835-842, 1996 2) 小山嵩夫 : わが国でどの位の女性がホルモン補充療法を受けているか.日更年医誌, 3 : 256, 1966 19) Grant ECG, Antony HM, Myhill S, Price EH, Steel CM : Breast cancer and hormone exposure. Lancet, 348 : 682-1996 12) Tang M, Jacobs D, Stern Y, et al : Effect of oestrogen during menopause on risk and age at on-set of Alzheimaer's disease. Lancet, 348 : 429432, 1996 10) Grodstein F, Stampfer MJ, Manson JE, Colditz GA, Willett WC, Joffe M, Rosner B, Speizer FE, Hennekens CH : Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. N Engl J Med, 335 : 453-461, 1996 8) Beresford SAA, Weiss NS, Voigt LF, McKnight B : Risk of endometrial cancer in relation to use of oestrogen combined with cyclic progestagen therapy in postmenopausal women. Lancet, 349 : 458-461, 1997 25) Yang NN, Venugopalan M, Hardikar S, Glasebrook A : Identification of an estrogen responseelement activated by metabolites of 17β-estradiol and raloxifene. Science, 273 : 1222-1225, 1996 |
| References_xml | – reference: 2) 小山嵩夫 : わが国でどの位の女性がホルモン補充療法を受けているか.日更年医誌, 3 : 256, 1966 – reference: 5) The Writing Group for the PEPI Trial : Effects of hormone replacement therapy on endometrial histology in postmenopausal women. JAMA, 275 : 370-375, 1996 – reference: 9) Grodstein F, Stampfer MJ, Colditz GA, Willett WC, Manson JE, Joffe M, Rosner B, Fuchs C, Hankinson S, Hunter DJ, Hennekens CH, Speizer FE : Postmenopausal hormone therapy and mortality. N Engl J Med, 336 : 1769-1775, 1997 – reference: 13) Kawaa C, Resnick S, Morrison A, Broolmeyer R, Corrada M, Zonderman A, Bacal C, Lingle DD, Metter E : A prospective study of estrogen replacement therapy and the risk of developing Alzheimer's disease. The Baltimore Longitudinal Study of Aging. Am Acad Neurology, 48 : 1517-1521, 1997 – reference: 16) Longacre TA, Bartow SA : A correlative morphologic study of human breast and endometrium in the menstrual cycle. Am J Surg Pathol, 10 : 382-393, 1986 – reference: 17) Ferguson DJP, Anderson TJ : Morphological evaluation of cell turnover in relation to the menstrual cycle in the “resting” human breast. Br J Cancer, 44 : 177-181, 1981 – reference: 1) Collaborative Group on Hormonal Factors in Breast Cancer (Beral V, et al) : Breast cancer and hormone replacement therapy : collaborative reanalysis of data from 51 epidemiological studies of 52705 women with breast cancer and 108411 women without breast cancer. Lancet, 350 : 1047-1059, 1997 – reference: 25) Yang NN, Venugopalan M, Hardikar S, Glasebrook A : Identification of an estrogen responseelement activated by metabolites of 17β-estradiol and raloxifene. Science, 273 : 1222-1225, 1996 – reference: 19) Grant ECG, Antony HM, Myhill S, Price EH, Steel CM : Breast cancer and hormone exposure. Lancet, 348 : 682-1996 – reference: 15) Daly E, Vessey MP, Hawkins MM, Carson JL, Gough P, Marsh S : Risk of venous thromboembolism in users of hormone replacement therapy. Lancet, 348 : 977-980, 1996 – reference: 14) Bilezekian JP : Major issues regarding estrogen replacement therapy in postmenopausal women. J Women Health, 3 : 273-282, 1994 – reference: 11) Gould E, Woolley CS, Frankfurt M, McEwen BS : Gonadal steroids regulate dendritic spine density in hippocampal pyramidal cells in adulthood. J Neurosci, 46 : 1286-1291, 1990 – reference: 24) Draper MW, Flowers DE, Huster WJ, Neild JA, Harper KD, Arnaud C : A controlled trial of raloxifene (LY 139481) HC1 : impact on bone turnover and serum lipid profile in healthy postmenopausal women. J Bone Miner Res, 11 : 835-842, 1996 – reference: 4) 研修ノート;産婦人科外来の薬物療法;日本母性産婦人科医会編;50, 平成6年10月, 103-105 – reference: 7) The Writing Group for the PEPI Trial : Effects of estrogen or estrogen/progestagen regimens on heart disease risk factors in postmenopausal women. The Postmenopausal Estrogen/Progestagen Trial. JAMA, 273 : 199-208, 1995 – reference: 21) Mills PK, Beeson WL, Phillips RL, Fraser GE : Prospective study of exogenous hormone use and breast cancer in Seventh-Day Adventists. Cancer, 64 : 591-597, 1989 – reference: 22) Colditz GA, Hankinson SE, Hunter DJ, Willett WC, Manson JE, Stampfer MJ, Hennekens C, Rosner B, Speizner FE : The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. N Engl J Med, 332 : 1589-1593, 1995 – reference: 23) Tavani A, Braga C, Vecchia CL, Negri E, Franceschi S : Hormone replacement treatment and breast cancer risk : An age-specific analysis. Cancer Epidem, Biomarkers & Prevention, 6 : 11-14, 1997 – reference: 20) 坂元吾偉 : 悪性疾患の病理学的解釈.産婦人科の世界, 49 : 22-30, 1997 – reference: 6) Jick SS, Walker AM, Jick H : Estrogens, progesterone, and endometrial cancer. Epidemiology, 4 : 20-24, 1993 – reference: 3) Breckwoldt M, Keck C, Karck U : Benefits and risks of hormone replacement therapy (HRT).J Steroid Biochem Molec Biol, 53 : 205-208, 1995 – reference: 12) Tang M, Jacobs D, Stern Y, et al : Effect of oestrogen during menopause on risk and age at on-set of Alzheimaer's disease. Lancet, 348 : 429432, 1996 – reference: 18) Key TJA, Pike MC : The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer. Eur J Cancer Clin Oncol, 24 : 29-43, 1988 – reference: 8) Beresford SAA, Weiss NS, Voigt LF, McKnight B : Risk of endometrial cancer in relation to use of oestrogen combined with cyclic progestagen therapy in postmenopausal women. Lancet, 349 : 458-461, 1997 – reference: 10) Grodstein F, Stampfer MJ, Manson JE, Colditz GA, Willett WC, Joffe M, Rosner B, Speizer FE, Hennekens CH : Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. N Engl J Med, 335 : 453-461, 1996 |
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| Title | ホルモン補充療法と乳癌 |
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