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Medicineworld.org: Hormone replacement therapy and breast cancer

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Hormone replacement therapy and breast cancer




The use of postmenopausal hormone treatment has decreased over time in the United States, which scientists suggest may play a key role in the declining rate of atypical ductal hyperplasia, a known risk factor for breast cancer.

"Postmenopausal hormone therapy is linked to increased rates of non-malignant breast biopsies, and early and late stages of cancer. Atypical ductal hyperplasia is linked to the use of postmenopausal hormone therapy and its rates have decreased with the decline in use of this therapy," said researcher Tehillah Menes, M.D., who was the chief of breast service in the Department of Surgery at Elmhurst Hospital Center, New York, when this study was conducted.

Details of the findings appear in Cancer Epidemiology, Biomarkers & Prevention, which is a journal of the American Association for Cancer Research.



Hormone replacement therapy and breast cancer
Karla Kerlikowske, M.D., is a professor of medicine and epidemiology and biostatistics at the University of California, San Francisco.


Atypical ductal hyperplasia is abnormal cells that grow in the milk ducts of the breast. Prior research has shown that women who are diagnosed with atypical ductal hyperplasia are at a three- to five-fold increased risk of developing breast cancer.

Using data from the Breast Cancer Surveillance Consortium, Menes and his colleagues examined the rates of atypical ductal hyperplasia to determine risk factors and rates for more than 2.4 million mammography studies with and without breast cancer.

Between 1996 and 2005, the scientists observed that postmenopausal hormone treatment use decreased from 35 percent to 11 percent; atypical ductal hyperplasia decreased from 5.5 per 10,000 mammograms in 1999 to 2.4 in 2005. Cases of atypical ductal hyperplasia linked to cancer reached a peak of 4.3 per 10,000 mammograms in 2003, but decreased to 3.3 in 2005.

"The rate of atypical hyperplasia declined, which we didn't expect to see with the increased use of mammography to identify abnormal lesions," said researcher Karla Kerlikowske, M.D., professor of medicine and epidemiology and biostatistics, University of California, San Francisco. "We did not expect to find a decline in rate of atypical ductal hyperplasia with a decline in postmenopausal hormone therapy use."

Findings also showed that when atypical ductal hyperplasia is diagnosed with an associated breast cancer, it is commonly not an aggressive type of cancer. It is commonly linked to low-grade cancers or those at an early stage, providing evidence to support the theory of a separate pathway for development of low-grade and high-grade breast cancers, as per Menes.

"These findings help clarify the different pathways to the development of breast cancer and the role of postmenopausal hormone therapy in increasing the rates of breast cancer," Menes concluded.

Kerlikowske suggested that future research should focus on the influence of exogeneous hormone treatment on non-malignant proliferative lesions of the breast.


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Did you know?
The use of postmenopausal hormone treatment has decreased over time in the United States, which scientists suggest may play a key role in the declining rate of atypical ductal hyperplasia, a known risk factor for breast cancer. "Postmenopausal hormone therapy is linked to increased rates of non-malignant breast biopsies, and early and late stages of cancer. Atypical ductal hyperplasia is linked to the use of postmenopausal hormone therapy and its rates have decreased with the decline in use of this therapy," said researcher Tehillah Menes, M.D., who was the chief of breast service in the Department of Surgery at Elmhurst Hospital Center, New York, when this study was conducted.

Medicineworld.org: Hormone replacement therapy and breast cancer

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