What is the increased risk of breast cancer in women with a history of postmenopausal hormone use?

Updated: Dec 26, 2019
  • Author: Graham A Colditz, MD, DrPH; Chief Editor: Chandandeep Nagi, MD  more...
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Answer

Answer

The risk associated with postmenopausal hormone use was assessed in a number of specific subgroups in the pooled analysis. [41] Risk did not appear to vary according to reproductive history, alcohol intake, smoking history, or family history of breast cancer. [47]

However, the RRs associated with 5 or more years of postmenopausal hormone use were highest among the leanest women (P for heterogeneity=0.001); this interaction has been consistently observed. [46] Risk of unopposed estrogen therapy is also more clearly observed to increase with duration of use among women with bilateral oophorectomy than those without, [48] again consistent with precise statistical control for underlying risk of breast cancer, as age at menopause is more accurately assessed in women undergoing bilateral oophorectomy than in those who have hysterectomy without oophorectomy. This consistent finding that risk of unopposed estrogen is attenuated among overweight and obese women may account for the apparent lower risk of breast cancer among women in the WHI trial of unopposed estrogen, given the overweight and obese population included in the trial. [49]


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