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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Sex hormone levels and risk of breast cancer with estrogen plus progestin
Journal of the National Cancer Institute, Volume 105, No. 19, Year 2013
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Description
Background Although high endogenous sex hormone levels and estrogen plus progestin (E+P) therapy are associated with increased breast cancer risk, it is unknown whether pretreatment levels of sex hormones modify E+P effect on breast cancer. Methods We conducted a nested case-control study within the Women's Health Initiative randomized clinical trial of E+P. The trial enrolled 16608 postmenopausal women aged 50 to 79 years with intact uterus and no breast cancer history. During a mean of 5.6 years of follow-up, 348 incident breast cancer case subjects were identified and matched with 348 control subjects. Case and control subjects had their sex hormone levels measured at baseline (estrogens, testosterone, progesterone, and sex hormone-binding globulin [SHBG]) and year 1 (estrogens and SHBG) using sensitive assays. All statistical tests were two-sided. Results Statistically significant elevations in breast cancer risk were seen with greater pretreatment levels of total estradiol (Ptrend =. 04), bioavailable estradiol (Ptrend =. 03), estrone (P trend =. 007), and estrone sulfate (Ptrend =. 007). E+P increased all measured estrogens and SHGB at year 1 (all P <. 001). The effect of E+P on breast cancer risk was strongest in women whose pretreatment levels of total estradiol, bioavailable estradiol, and estrone were in the lowest quartiles. For example, the odds ratio for E+P relative to placebo was 2.47 (95% confidence interval [CI] = 1.28 to 4.79) in the lowest total estradiol quartile, compared with 0.96 (95% CI = 0.44 to 2.09) in the highest total estradiol quartile; Pinteraction =. 04). Conclusions Women with lower pr-treatment endogenous estrogen levels were at greater risk of breast cancer during E+P therapy compared with those with higher levels. Further studies are warranted to confirm these findings. © 2013 © The Author 2013. Published by Oxford University Press.
Authors & Co-Authors
Farhat, Ghada N.
United States, San Francisco
California Pacific Medical Center
Lebanon, Al Koura
University of Balamand
Parimi, Neeta
United States, San Francisco
California Pacific Medical Center
Chlebowski, Rowan T.
United States, Torrance
Harbor-ucla Medical Center
Manson, Jo Ann E.
United States, Boston
Brigham and Women's Hospital
Anderson, Garnet L.
United States, Seattle
Fred Hutchinson Cancer Research Center
Huang, Alison J.
United States, San Francisco
University of California, San Francisco
Vittinghoff, Eric V.
United States, San Francisco
University of California, San Francisco
Lee, Jennifer S.
United States, Davis
University of California, Davis
LaCroix, Andrea Z.
United States, Seattle
Fred Hutchinson Cancer Research Center
Cauley, Jane A.
United States, Pittsburgh
University of Pittsburgh Graduate School of Public Health
Jackson, Rebecca D.
United States, Columbus
The Ohio State University
Grady, Deborah
United States, San Francisco
University of California, San Francisco
Lane, Dorothy S.
United States, Stony Brook
Renaissance School of Medicine at Stony Brook University
Phillips, Lawrence S.
United States, Atlanta
Emory University
Simon, Michael S.
United States, Detroit
Wayne State University
Cummings, Steven Ron
United States, San Francisco
California Pacific Medical Center
Statistics
Citations: 35
Authors: 16
Affiliations: 12
Identifiers
Doi:
10.1093/jnci/djt243
ISSN:
00278874
e-ISSN:
14602105
Research Areas
Cancer
Study Design
Randomised Control Trial
Cohort Study
Case-Control Study
Participants Gender
Female