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J Natl Cancer Inst. 2015 Nov 26;108(4). pii: djv361. doi: 10.1093/jnci/djv361. Print 2016 Apr.

Postmenopausal Female Hormone Use and Estrogen Receptor-Positive and -Negative Breast Cancer in African American Women.

Author information

1
Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK). lrosenbe@bu.edu.
2
Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).

Abstract

BACKGROUND:

Use of estrogen with progestin (combination therapy) is associated with increased incidence of estrogen receptor-positive (ER+) breast cancer in observational studies and randomized trials among postmenopausal white women. Whether this is also the case among African American women is not established.

METHODS:

Using data from the AMBER consortium collected from 1993 to 2013, we assessed use of estrogen alone and of combination therapy in relation to ER+ and ER-negative (ER-) breast cancer risk in postmenopausal African American women, based on 1132 ER+ case patients, 512 ER- case patients, and 6693 control patients. Odds ratios (ORs) and confidence intervals (CIs) were estimated using multinomial logistic regression with control for breast cancer risk factors.

RESULTS:

Forty-seven percent of control patients had used estrogen alone, combination therapy, or both. The odds ratio for ER+ breast cancer associated with combination use, relative to never use of either estrogen alone or combination therapy, was 1.50 (95% CI = 1.25 to 1.79). The increase was greater for recent (OR = 1.55, 95% CI = 1.21 to 1.99) and long-term use (OR = 1.75, 95% CI = 1.13 to 2.73) and among nonobese women (OR = 1.91, 95% CI = 1.29 to 2.83). Breast cancer risk was increased regardless of the interval between onset of menopause and initiation of combination use (OR = 1.43, 95% CI = 1.11 to 1.85, for <5 year interval; OR = 1.78, 95% CI = 1.34 to 2.37, for ≥5 year interval). Combination use was not associated with risk of ER- breast cancer, and use of estrogen alone was not associated with risk of either ER+ or ER- breast cancer.

CONCLUSION:

Use of estrogen with progestin increases risk of ER+ breast cancer in African American women. A decrease in use would be expected to reduce the number of ER+ cancers.

PMID:
26613937
PMCID:
PMC4857155
DOI:
10.1093/jnci/djv361
[Indexed for MEDLINE]
Free PMC Article

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