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Prediagnostic use of hormone therapy and mortality after breast cancer.

Newcomb, Polly A and Egan, Kathleen M and Trentham-Dietz, Amy and Titus-Ernstoff, Linda and Baron, John A and Hampton, John M and Stampfer, Meir J and Willett, Walter C (2008) Prediagnostic use of hormone therapy and mortality after breast cancer. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 17 (4). pp. 864-871. ISSN 1055-9965

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BACKGROUND: A few studies have observed reduced breast cancer mortality in women who used hormone therapy before diagnosis. Due to the high prevalence of past and current hormone use, it is important to investigate whether these preparations are related to breast cancer mortality. METHODS: To evaluate the influence of prediagnostic use of hormone therapy on breast cancer mortality, a prospective cohort of 12,269 women ages 50 years or more diagnosed with incident invasive breast cancer and residents of Wisconsin, Massachusetts, or New Hampshire were enrolled in three phases beginning in 1988. They were followed for death until December 31, 2005, using the National Death Index. Cumulative mortality and multivariable adjusted hazard rate ratios for breast cancer and other mortality causes were calculated for women according to any hormone therapy use, and for exclusive use of estrogen or estrogen-progestin (EP). RESULTS: During an average 10.3 years of follow-up, 1,690 deaths from breast cancer were documented. Cumulative mortality from breast cancer was lower among hormone therapy users, specifically current users at the time of diagnosis, and EP users, compared with nonusers. Adjusted survival varied by type and duration of hormone therapy before diagnosis. A reduced risk of death from breast cancer was associated with EP preparations (hazard rate ratio, 0.73; 0.59-0.91) and with > or =5 years of EP use (0.60; 0.43-0.84). No association was observed for women who were former or current users of E-alone preparations. CONCLUSIONS: Although use of combined EP preparations increases breast cancer risk, in this study, use of these hormones before diagnosis was associated with reduced risk of death after a breast cancer diagnosis. The better survival among users, particularly of EP, persisted after adjustment of screening, stage, and measured confounders.

Item Type: Article or Abstract
Additional Information: This article is available to subscribers only via the URL above for the first 12 months post-publication.
DOI: 10.1158/1055-9965.EPI-07-0610
PubMed ID: 18381475
PMCID: PMC2780320
Grant Numbers: R01 CA067264-09, R01 CA047147-17, R01 CA047305-12
Keywords or MeSH Headings: Aged; Breast Neoplasms/epidemiology/mortality/prevention & control; Case-Control Studies; Cohort Studies; Death Certificates; Estrogen Replacement Therapy/statistics & numerical data; Female; Humans; Incidence; Middle Aged; Survival Analysis;
Subjects: Diseases > Solid tumors > Breast cancer
Therapeutics > Drug Therapy
Research Methodologies > Epidemiology
Depositing User: Library Staff
Date Deposited: 31 Mar 2009 18:25
Last Modified: 14 Feb 2012 14:42

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