ArticleJournal of the National Cancer Institute2013
Estrogen plus progestin and breast cancer incidence and mortality in the Women's Health Initiative Observational Study.
Article in Journal of the National Cancer Institute, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 4 of them syntheses that pooled it.
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Who cites it
77 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Exposure to second-hand smoke and breast cancer risk in non-smoking women: a comprehensive systematic review and meta-analysis.British journal of cancer · 2024Pooled it
- Effect of aspirin use on survival benefits of breast cancer patients: A meta-analysis.Medicine · 2021Pooled it
- The management of menopause in women with a history of endometriosis: a systematic review.Human reproduction update · 2017Pooled it
- The LSP1 rs3817198 T > C polymorphism contributes to increased breast cancer risk: a meta-analysis of twelve studies.Oncotarget · 2016Pooled it
- Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative.International journal of cancer · 2017Trial
- Distinct cognitive effects of estrogen and progesterone in menopausal women.Psychoneuroendocrinology · 2015Trial
- Nonsteroidal Anti-Inflammatory Drug and Aspirin Use in Relation to Lung Cancer Risk among Postmenopausal Women.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2015Trial
- Effect of the use of hormonal replacement therapy on breast cancer prognosis: A systematic review and meta-analysis.Oncology letters · 2026Article
- Review
- Menopausal hormone therapy and incidence, mortality, and survival of breast cancer subtypes: a prospective cohort study.Breast cancer research : BCR · 2024Article
- Horizons in Endometriosis: Proceedings of the Montreux Reproductive Summit, 14-15 July 2023.Facts, views & vision in ObGyn · 2024Article
- The 100 top-cited articles in menopausal syndrome: a bibliometric analysis.Reproductive health · 2024Article
- Machine-learning methods based on the texture and non-texture features of MRI for the preoperative prediction of sentinel lymph node metastasis in breast cancer.Translational cancer research · 2023Article
- Trajectories of body mass index in adulthood and risk of subtypes of postmenopausal breast cancer.Breast cancer research : BCR · 2023Article
- Cancer prevalence, incidence, and mortality rates in Afghanistan in 2020: A review study.Cancer reports (Hoboken, N.J.) · 2023Review
- Sex hormones in the risk of breast cancer: a two-sample Mendelian randomization study.American journal of cancer research · 2023Article
- Delineating the role of osteoprotegerin as a marker of breast cancer risk among women with a BRCA1 mutation.Hereditary cancer in clinical practice · 2022Review
- Gene expression trend changes in breast cancer populations over two decades: insights from The Cancer Genome Atlas database.Hereditas · 2022Article
- Review
- Pueratin improves diminished ovarian reserve by inhibiting apoptosis.Experimental and therapeutic medicine · 2021Article
17 more citing papers are in PubMed but not listed here.
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14 authors.
Funding
Abstract
backgroundIn the Women's Health Initiative (WHI) randomized trial, estrogen plus progestin increased both breast cancer incidence and mortality. In contrast, most observational studies associate estrogen plus progestin with favorable prognosis breast cancers. To address differences, a cohort of WHI observational study participants with characteristics similar to the WHI clinical trial was studied.
methodsWe identified 41 449 postmenopausal women with no prior hysterectomy and mammogram negative within 2 years who were either not hormone users (n = 25 328) or estrogen and progestin users (n = 16 121). Multivariable-adjusted Cox proportional hazard regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CI). All statistical tests were two-sided.
resultsAfter a mean of 11.3 (SD = 3.1) years, with 2236 breast cancers, incidence was higher in estrogen plus progestin users than in nonusers (0.60% vs 0.42%, annualized rate, respectively; HR = 1.55, 95% CI = 1.41 to 1.70, P < .001). Women initiating hormone therapy closer to menopause had higher breast cancer risk with linear diminishing influence as time from menopause increased (P < .001). Survival after breast cancer, measured from diagnosis, was similar in combined hormone therapy users and nonusers (HR = 1.03, 95% CI = 0.79 to 1.35). On a population basis, there were somewhat more deaths from breast cancer, measured from cohort entry (HR = 1.32, 95% CI = 0.90 to 1.93, P = .15), and more all-cause deaths after breast cancer (HR = 1.65, 95% CI = 1.29 to 2.12, P < .001) in estrogen plus progestin users than in nonusers.
conclusionsConsistent with WHI randomized trial findings, estrogen plus progestin use is associated with increased breast cancer incidence. Because prognosis after diagnosis on combined hormone therapy is similar to that of nonusers, increased breast cancer mortality can be expected.
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