All British Columbia (Canada) women under 75 years of age who were diagnosed with breast cancer during 1988–89 were asked to complete a postal questionnaire which included detailed information on menopausal estrogen use. Controls were drawn from the Provincial Voters List, matched by five-year age category to the cases. The present analysis consists of 699 cases and 685 controls who were postmenopausal due to natural causes or to a hysterectomy. There was no overall increase in risk of breast cancer associated with ever-use of unopposed estrogen (odds ratio [OR] = 1.0,95 percent confidence interval [CI] = 0.8–1.3). For estrogen use of 10 years or longer, the relative risk [RR] was 1.6 (CI = 1.1–2.5). The risk estimate for current users was somewhat elevated (OR = 1.4, CI = 1.0–2.0). Compared with women who never used hormone preparations, women who had used estrogen plus progestogen had an RR of 1.2 (CI = 0.6–2.2). Our results suggest that ever-use of estrogen, with or without progestogen, does not appreciably increase the risk of breast cancer. However, long-term and recent use of unopposed estrogen may be associated with a moderately increased risk.
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References
Casagrande J, Gerkins V, Henderson BE, Mack T, Pike MC. Brief communication: Exogenous estrogens and breast cancer in women with natural menopause. JNCI 1976; 56: 839–41.
Hoover R, Gray LA, Cole P, MacMahon B. Menopausal estrogens and breast cancer. N Engl J Med 1976; 295: 401–5.
Startwell PE, Arthes FG, Tonascia JA. Exogenous hormones, reproductive history and breast cancer. JNCI 1977; 59: 1589–92.
Brinton LA, Williams RR, Hoover RN, et al. Breast cancer risk factors among screening program participants. JNCI 1979; 62: 37–44.
Ross RK, Paganini-Hill A, Gerkins VR, et al. A casecontrol study of menopausal estrogen therapy and breast cancer. JAMA 1980; 243: 1635–9.
Jick H, Walker AM, Watkins RN, et al. Replacement estrogens and breast cancer. Am J Epidemiol 1980; 112: 586–94.
Brinton LA, Hoover RN, Szklo M, et al. Menopausal estrogen use and risk of breast cancer. Cancer 1981; 47: 2517–22.
Kelsey JL, Fisher DB, Holford TR, et al. Exogenous estrogens and other factors in the epidemiology of breast cancer. JNCI 1981; 67: 327–33.
Hoover R, Glass A, Azevedo D, Milne K. Conjugated estrogens and breast cancer risk in women. JNCI 1981; 67: 815–20.
Lawson DH, Jick H, Hunter JR, et al. Exogenous estrogens and breast cancer. Am J Epidemiol 1981; 114: 710–13.
Hulka BS, Chambless LE, Deubner DC, et al. Breast cancer and estrogen replacement therapy. Am J Obstet Gynecol 1982; 143: 638–44.
Hiatt RA, Bawol R, Friedman GD, Hoover R. Exogenous estrogen and breast cancer after bilateral oophorectomy. Cancer 1984; 54: 139–44.
Kaufman DW, Miller DR, Rosenberg L, et al. Noncontraceptive estrogen use and the risk of breast cancer. JAMA 1984; 252: 63–7.
Brinton LA, Hoover R, Fraumeni JFJr. Menopausal estrogens and breast cancer risk: an expanded case-control study. Br J Cancer 1986; 54: 825–32.
La Vecchia C, Decarli A, Parazzini F, Gentile A, Liberati C, Franceschi S. Noncontraceptive oestrogens and the risk of breast cancer in women. Int J Cancer 1986; 38: 853–8.
McDonald JA, Weiss NS, Daling JR, Francis AM, Polissar L. Menopausal estrogen use and the risk of breast cancer. Breast Cancer Res Treat 1986; 7: 193–9.
Nomura AMY, Kolonel LN, Hirohata T, Lee J. The association of replacement estrogens with breast cancer. Int J Cancer 1986; 37: 49–53.
Buring JE, Hennekens CH, Lipnick RJ, et al. A prospective cohort study of postmenopausal hormone use and risk of breast cancer in US women. Am J Epidemiol 1987; 125: 939–47.
Hunt K, Vessey M, McPherson K, Coleman M. Longterm surveillance of mortality and cancer incidence in women receiving hormone replacement therapy. Br J Obstet Gynecol 1987; 94: 620–35.
Wingo PA, Layde PM, Lee NC, Rubin G, Ory HW. The risk of breast cancer in postmenopausai women who have used estrogen replacement therapy. JAMA 1987; 257: 209–15.
Bergkvist L, Adami H-O, Persson I, Hoover R, Schairer C. The risk of breast cancer after estrogen and estrogenprogestin replacement. N Engl J Med 1989; 321: 293–7.
Thomas DB, Persing JP, Hutchinson WB. Exogenous estrogens and other risk factors for breast cancer in women with benign breast diseases. JNCI 1982; 69: 1017–23.
Rohan TE, McMichael AJ. Non-contraceptive exogenous oestrogen therapy and breast cancer. Med J Aust 1988; 148: 217–21.
Ewertz M. Influence of non-contraceptive exogenous and endogenous sex hormones on breast cancer risk in Denmark. Int J Cancer 1988; 42: 832–8.
Dupont WD, Page DL, Rogers LW, et al. Influence of exogenous estrogens, proliferative breast disease, and other variables on breast cancer risk. Cancer 1989; 63: 948–57.
Mills PK, Beeson WL, Phillips RL, Fraser GE. Prospective study of exogenous hormone use and breast cancer in Seventh-day Adventists. Cancer 1989; 64: 591–7.
Colditz GA, Stampfer MJ, Willett WC, Hennekens CH, Rosner B, Speizer FE. Prospetive study of estrogen replacement therapy and risk of breast cancer in postmenopausal women. JAMA 1990; 264: 2648–53.
Gambrell RDJr, Maier RC, Sanders BI. Decreased incidence of breast cancer in postmenopausal estrogen-progestogen users. Obstet Gynecol 1983; 62: 435–43.
Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy. II. A prospective study in the relationship to carcinoma and cardiovascular and metabolic problems. Obstet Gynecol 1979; 54: 74–9.
Kaufman DW, Palmer JR, Mouzon J, et al. Estrogen replacement therapy and the risk of breast cancer: results from the case-control surveillance study. Am J Epidemiol 1991; 134: 1375–85.
Palmer JR, Rosenberg, Clarke EA, et al. Breast cancer risk after estrogen replacement therapy; results from the Toronto breast cancer study. Am J Epidemiol 1991; 134: 1386–95.
Breslow NE, Day NE. Statistical Methods in Cancer Research Vol. 1. The Analysis of Case-control Studies. International Agency for Research on Cancer, 1980; Lyon, France: IARC Sci. Pub. No. 32: 192.
Dupont W, Page D. Menopausal estrogen replacement therapy and breast cancer. Arch Intern Med 1991; 151: 67–72.
Steinberg K, Thacker S, Smith S, et al. A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. JAMA 1991; 265: 1985–90.
Amstrong BK. Oestrogen therapy after menopause—boon or bane? Med J Aust. 1988; 148: 213–4.
Grady D, Ernster V. Invited commentary: Does postmenopausal hormone therapy cause breast cancer? Am J Epidemiol 1991; 134: 1396–400.
Voigt LF, Weiss NS, Chu J, Daling JR, McKnight B, Van Belle G, Progestogen supplementation of exogenous oestrogens and risk of endometrial cancer. Lancet 1991; 338: 274–77.
Gambrell RJr. Prevention of endometrial cancer with progestogens. Maturitas 1986; 8: 159–68.
Russo IH, Russo J. Hormone prevention of mammary carcinogenesis: a new approach in anticancer research. Anticancer Res 1988; 8: 1247–64.
Key TJA, Pike MC. The role of oestrogens and progestogens in the epidemiology and prevention of breast cancer. Eur J Cancer Clin Oncol 1988; 24: 29–43.
Ernster VL, Cummings SR. Progesterone and breast cancer. Obstet Gynecol 1986; 68: 715–7.
Spengler RF, Clarke EA, Woolever CA, et al. Exogenous estrogens and endometrial cancer: a case-control study and assessment of potential biases. Am J Epidemiol 1981; 114: 497–506.
Goodman MT, Nomura AMY, Wilkens LR, et al. Agreement between interview information and physician records on history of menopausal estrogen use. Am J Epidemiol 1990; 131: 815–25.
Paganini-Hill A, Ross RK. Reliability of recall of drug usage and other health-related information. Am J Epidemiol 1982; 116: 114–22.
Persson I, Bergkvist L, Adami H-O. Reliability of women's histories of climacteric oestrogen treatment assessed by prescription forms. Int J Epidemiol 1987; 16: 222–8.
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Drs Yang and Band, and Mr Gallagher are with the British Columbia Cancer Agency, Vancouver, Britsh Columbia, Canada. Authors are also affiliated with the School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA (Drs Yang, Daling, White, and Weiss), and the Fred Hutchinson Cancer Research Center, Seattle, WA, USA (Drs Daling, White, and Weiss). Address correspondence to Mr Gallagher, Division of Epidemiology, Biometry and Occupational Oncology, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, BC, Canada, V5Z 4E6. This project is funded partially by Health and Welfare Canada, Grant #6610-1834-55 and by Workers Compensation Board of BC.
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Yang, C.P., Daling, J.R., Band, P.R. et al. Noncontraceptive hormone use and risk of breast cancer. Cancer Causes Control 3, 475–479 (1992). https://doi.org/10.1007/BF00051360
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DOI: https://doi.org/10.1007/BF00051360