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Updated: Feb 2, 2026

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更年期激素治疗和乳腺癌
Anne Gompel1, Richard Simcock2
1Département de Gynécologie, Université Paris Cité, Hôpital Port-Royal Cochin, Paris, France.
The lancet. Diabetes & endocrinology
|January 31, 2026
概括
更年期激素治疗 (MHT) 有效地管理症状,但乳腺癌风险因MHT类型和个体因素而异. 个性化风险评估和了解治疗差异对于明智决策至关重要.
科学领域:
- 生殖内分泌和瘤学 生殖内分泌和瘤学
- 基于证据的医学是基于证据的医学.
背景情况:
- 更年期激素治疗 (MHT) 对管理高潮症状非常有效,显著影响女性的生活质量.
- 大约40%的女性生活是在绝经后度过的,这凸显了MHT的相关性.
- 乳腺癌风险是MHT决策的主要考虑因素.
研究的目的:
- 审查有关MHT和乳腺癌风险的当代证据.
- 综合不同MHT配方及其相关风险的发现.
- 为考虑MHT的女性提供共享决策的信息.
主要方法:
- 随机对照试验和观察性研究的系统审查.
- 分析证据,考虑MHT成分的药理学区别.
- 评估MHT,基线乳腺癌风险和可修改风险因素之间的相互作用.
主要成果:
- 在没有子宫的女性中,仅用雌激素治疗似乎与结合雌激素-孕激素MHT相比,乳腺癌风险较低.
- 根据观察数据,微化孕激素和二激素可能与其他孕激素相比较低的乳腺癌风险有关.
- 在开始MHT之前,基线乳腺癌风险评估和患者教育至关重要.
结论:
- 对于MHT的共享决策应该包括个性化乳腺癌风险评估.
- 了解与不同类型的MHT相关的乳腺癌风险变化至关重要.
- 需要进一步的随机研究来确认MHT中不同孕激素的乳腺癌风险比较.
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