What is the role of postmenopausal hormone use in the etiology of estrogen receptor–positive breast cancer?

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

Answer

Consistent evidence from larger epidemiologic studies shows combination estrogen plus progestin and unopposed estrogen therapy are associated with increased risk of estrogen receptor–positive breast cancer. [44] While the WHI did not observe any significant difference in the distribution of invasive cancer by receptor status, the trial had limited power to detect an association with fewer than 500 cases of breast cancer. While it has been suggested that risk is limited to lobular subtypes of breast cancer, most evidence does not support this claim, and, given the higher proportion of receptor-positive tumors in lobular rather than ductal cancers, a stronger RR observed for lobular cancer would be expected for this subset of breast cancers.


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