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Ann Intern Med. 1997 Dec 1;127(11):973-80.

The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer.

Author information

1
Division of Epidemiology, University of Minnesota, Minneapolis 55454, USA.

Abstract

BACKGROUND:

The risks and benefits of hormone replacement therapy (HRT) are of considerable interest and importance, especially in terms of whether they differ among subsets of women.

OBJECTIVE:

To determine whether HRT is associated with increased risks for breast cancer and total mortality in women with a family history of breast cancer.

DESIGN:

Prospective cohort study.

SETTING:

Population-based sample of midwestern post-menopausal women enrolled in an observational study of risk factors for cancer.

PARTICIPANTS:

Random sample of 41,837 female Iowa residents 55 to 69 years of age.

MEASUREMENTS:

Incidence rates of and relative risks for breast cancer (n = 1085) and total mortality (n = 2035) through 8 years of follow-up were calculated by using data from the State Health Registry of Iowa and the National Death Index.

RESULTS:

A family history of breast cancer was reported by 12.2% of the cohort at risk. Among women with a family history of breast cancer, those who currently used HRT and had done so for at least 5 years developed breast cancer at an age-adjusted annual rate of 61 cases per 10,000 person-years (95% CI, 28 to 94 cases); this rate was not statistically significantly higher than the rate in women who had never used HRT (46 cases per 10,000 person-years [CI, 36 to 55 cases]). Among women with a family history, those who used HRT had a significantly lower risk for total mortality than did women who had never used HRT (relative risk, 0.67 [CI, 0.51 to 0.89]), including total cancer-related mortality (relative risk, 0.75 [CI, 0.50 to 1.12]). The age-adjusted annual mortality rate for women using HRT for at least 5 years was 46 deaths per 10,000 person-years (CI, 19 to 74 deaths); this is roughly half the rate seen in women who had never used HRT (80 deaths per 10,000 person-years [CI, 69 to 92 deaths]).

CONCLUSIONS:

These data suggest that HRT use in women with a family history of breast cancer is not associated with a significantly increased incidence of breast cancer but is associated with a significantly reduced total mortality rate.

Comment in

  • ACP J Club. 1998 May-Jun;128(3):74.
PMID:
9412302
[Indexed for MEDLINE]

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