雌激素加孕激素以及绝经后妇女乳腺癌发病率和死亡率
Rowan T Chlebowski1, Garnet L Anderson, Margery Gass
1Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA. rchlebowski@gmail.com
JAMA
|October 21, 2010
概括
与雌激素加孕激素的联合激素治疗增加了绝经后妇女的乳腺癌发病率和死亡率. 癌症更常见于节点阳性,表明诊断时的更先进阶段.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 妇女健康 妇女健康
背景情况:
- 妇女健康倡议试验发现雌激素加孕激素的乳腺癌发病率增加.
- 这项试验的乳腺癌死亡率数据以前没有报告.
研究的目的:
- 评估雌激素加孕激素对累积乳腺癌发病率和死亡率的长期影响.
- 在平均随访11年后分析乳腺癌的结果.
主要方法:
- 16,608名绝经后妇女被随机分配给雌激素加孕激素或安慰剂.
- 从83%的幸存者中获得了乳腺癌发病率和死亡率的持续随访.
主要成果:
- 雌激素加孕激素显著增加了侵袭性乳腺癌发病率 (HR,1.25;P = .004).
- 激素治疗组中的癌症更有可能是节点阳性 (HR,1.78;P = .03).
- 雌激素加孕激素组的乳腺癌死亡率更高 (HR,1.96;P = .049).
结论:
- 结合雌激素加孕激素治疗与乳腺癌发病率和死亡率的增加有关.
- 增加的发病率包括高比例的节点阳性癌症.
- 组合激素治疗对乳腺癌的发展和不良结果具有显著的风险.
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