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| 单纯雌激素治疗与侵袭性乳腺癌风险 |
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| Unopposed Estrogen Therapy and the Risk of Invasive Breast Cancer |
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| Chen WY, Manson JE, Hankinson SE 2009/5/27 10:50:40 |
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| Arch Intern Med, 2006, |
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| View at Publisher |
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Abstract
Background:
Although short-term unopposed estrogen use does not seem to increase breast cancer risk, the effect of longer-term estrogen use remains unclear. We sought to assess the relationship between longer-term use of unopposed estrogen and the risk of invasive breast cancer over an extended follow-up period.
Methods:
Within the Nurses' Health Study, a prospective cohort study, we observed 11 508 postmenopausal women who had a hysterectomy and reported information on estrogen use at baseline (1980). The study population was expanded every 2 years to include women who subsequently became postmenopausal and had a hysterectomy, so that 28 835 women were included in the final follow-up period (2000–2002). Estrogen use was assessed from self-reported data on biennial questionnaires. The main outcome was invasive breast cancer.
Results:
A total of 934 invasive breast cancers were included in the analysis. Breast cancer risk increased with duration of unopposed estrogen use among longer-term users with the highest risk seen in cancers positive for estrogen receptor (ER +) and progesterone receptor (PR +). The multivariate relative risks (RRs) and 95% confidence intervals (CIs) for breast cancer with current use of unopposed estrogen for less than 5 years, 5 to 9.9 years, 10 to 14.9 years, 15 to 19.9 years, and 20 years or longer were, respectively, 0.96 (95% CI, 0.75–1.22), 0.90 (95% CI, 0.73–1.12), 1.06 (95% CI, 0.87–1.30), 1.18 (95% CI, 0.95–1.48), and 1.42 (95% CI, 1.13–1.77) (P for trend <.001). The risk of ER + /PR + breast cancers was noted to be statistically significant after 15 years of current use (RR, 1.48; 95% CI, 1.05–2.07).
Conclusion:
Users of unopposed estrogen were at increased risk of breast cancer but only after longer-term use. |
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 疾病资源中心
病例分析 [栏目介绍]
王燕燕 王曙
上海交通大学附属瑞金医院内分泌科
患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
医学数据库
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