Evidence map›Paper›PMID 29738414›Full record

Observational studyMenopause (New York, N.Y.)2018

Estrogen-alone therapy and invasive breast cancer incidence by dose, formulation, and route of delivery: findings from the WHI observational study.

Chrisandra Shufelt, C Noel Bairey Merz, Mary B Pettinger, Lydia Choi, Rowan Chlebowski, Carolyn J Crandall, Simin Liu, Dorothy Lane, Ross Prentice, JoAnn E Manson and 1 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Menopause (New York, N.Y.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 1 country.

Chrisandra ShufeltBarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA.
C Noel Bairey MerzBarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA.
Mary B PettingerFred Hutchinson Cancer Research Center, Seattle, WA.
Lydia ChoiKarmanos Cancer Institute Wayne State University, Detroit, MI.
Rowan ChlebowskiDepartment of Medical Oncology and Developmental Therapeutics, City of Hope National Medical Center, Duarte, CA.
Carolyn J CrandallDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA.
Simin LiuDepartment of Epidemiology, Brown University, Providence, RI.
Dorothy LaneDepartment of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY.
Ross PrenticeFred Hutchinson Cancer Research Center, Seattle, WA.
JoAnn E MansonDepartment of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Womenʼs Health Initiative Investigators
Cedars-Sinai Smidt Heart Institute · USFred Hutch Cancer Center · USBrown University · USCity Of Hope National Medical Center · USHarvard University · USStony Brook University · USThe Barbara Ann Karmanos Cancer Institute · USUniversity of California, Los Angeles · US

Funding

ZONA-FREE HAMSTER OVA ASSAY AS AN INDICATOR OF MALE FERTILITYM01RR000425 · NCRR · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI ANDERSON, GAIL V · 1985 to 2011
$74.2M
Atherosclerosis, Immune Mediated Inflammation and Hypoestrogenemia in Young WomenK23HL127262 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI SHUFELT, CHRISANDRA LEE · 2016 to 2020
$988k
NCRR NIH HHS M01 RR000425NHLBI NIH HHS HHSN268201600001CNHLBI NIH HHS HHSN268201600002CNHLBI NIH HHS HHSN268201600003CNHLBI NIH HHS HHSN268201600004CNHLBI NIH HHS HHSN268201600018CNHLBI NIH HHS K23 HL127262NHLBI NIH HHS L30 HL138886
6 · The paper itself

Abstract

objectiveResearch on the relationships between different hormone therapy doses, formulation and routes of delivery, and subsequent breast cancer incidence has been limited. This study directly compared different estrogen doses, formulations, and route of delivery of estrogen alone among women with a hysterectomy in relation to invasive breast cancer incidence.

methodsThe Women's Health Initiative Observational Study is a large multicenter prospective cohort study conducted at 40 US sites. Analyses included 26,525 postmenopausal women with a hysterectomy, aged 50 to 79 years, at study entry, recruited between September, 1993 and December, 1998, with annual follow-up through September 12, 2005.

resultsAverage follow-up was 8.2 years. For conjugated equine estrogen (CEE) users, no difference was observed between low-dose CEE (<0.625 mg) compared with conventional-dose CEE (0.625 mg) for breast cancer (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.65, 1.48)]. Compared with conventional-dose CEE, transdermal estrogen was associated with a nonsignificant lower risk of invasive breast cancer (HR 0.75, 95% CI 0.47, 1.19). The low prevalence of transdermal use likely limited power for this comparison, and for a comparison of oral estradiol to conventional-dose CEE (HR 1.20, 95% CI 0.84, 1.39).

conclusionOur results indicate that invasive breast cancer risk did not differ appreciably in women with a hysterectomy using estrogen-alone when directly comparing different doses, formulations, and routes of delivery to the conventional oral CEE. These findings suggest that the lower breast cancer risk found in the WHI estrogen-alone trial may extend to lower doses of CEE. Additional research is needed to confirm these hypotheses.

Indexed as

Administration, CutaneousAdministration, OralAgedAged, 80 and overBreast NeoplasmsEstrogen Replacement TherapyEstrogensEstrogens, Conjugated (USP)FemaleFollow-Up StudiesHumansHysterectomyIncidenceMiddle AgedNeoplasm InvasivenessPostmenopauseEstrogensEstrogens, Conjugated (USP)

Identifiers

PMID29738414
PMCPMC6103839
OpenAlexW2801679479

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.