Skip to main content

Advertisement

SpringerLink
Log in

Use of menopausal hormone therapy and risk of ductal and lobular breast cancer among women 55–74 years of age

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

The Women’s Health Initiative (WHI) randomized trials found that use of combined estrogen and progestin menopausal hormone therapy (CHT) increases breast cancer risk, but use of unopposed estrogen hormone therapy (EHT) does not. However, several questions regarding the impact of hormone use on risk of different types of breast cancer and what thresholds of use confer elevations in risk remain. We conducted a population-based case–control study among women 55–74 years of age to assess the association between menopausal hormone use and risk of invasive ductal and invasive lobular breast carcinomas. Associations were evaluated using polytomous logistic regression and analyses included 880 ductal cases, 1,027 lobular cases, and 856 controls. Current EHT and CHT use were associated with 1.6-fold [95 % confidence interval (CI): 1.1–2.2] and 2.3-fold (95 % CI: 1.7–3.2) increased risks of lobular breast cancer, respectively, but neither was associated with risk of ductal cancer. Lobular cancer risk was increased after 9 years of EHT use, but after only 3 years of CHT use. Evidence across more than a dozen studies indicates that lobular carcinoma is the type of breast cancer most strongly influenced by menopausal hormones. Here, we characterize what thresholds of duration of use of both EHT and CHT that confer elevations in risk. Despite the rapid decline in hormone therapy use the WHI results were published, study of the hazards associated with these medications remains relevant given the estimated 38 million hormone therapy prescriptions that are still filled in the United States annually.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chlebowski RT, Hendrix SL, Langer RD, Stefanick ML, Gass M, Lane D, Rodabough RJ, Gilligan MA, Cyr MG, Thomson CA, Khandekar J, Petrovitch H, McTiernan A (2003) Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women’s Health Initiative Randomized Trial. JAMA 289:3243–3253

    Article  CAS  PubMed  Google Scholar 

  2. Li CI, Daling JR (2007) Changes in breast cancer incidence rates in the United States by histologic subtype and race/ethnicity, 1995 to 2004. Cancer Epidemiol Biomarkers Prev 16:2773–2780

    Article  PubMed  Google Scholar 

  3. Calle EE, Feigelson HS, Hildebrand JS, Teras LR, Thun MJ, Rodriguez C (2009) Postmenopausal hormone use and breast cancer associations differ by hormone regimen and histologic subtype. Cancer 115:936–945

    Article  CAS  PubMed  Google Scholar 

  4. Chen CL, Weiss NS, Newcomb P, Barlow W, White E (2002) Hormone replacement therapy in relation to breast cancer. JAMA 287:734–741

    Article  CAS  PubMed  Google Scholar 

  5. Daling JR, Malone KE, Doody DR, Voigt LF, Bernstein L, Coates RJ, Marchbanks PA, Norman SA, Weiss LK, Ursin G, Berlin JA, Burkman RT, Deapen D, Folger SG, McDonald JA, Simon MS, Strom BL, Wingo PA, Spirtas R (2002) Relation of regimens of combined hormone replacement therapy to lobular, ductal, and other histologic types of breast carcinoma. Cancer 95:2455–2464

    Article  CAS  PubMed  Google Scholar 

  6. Flesch-Janys D, Slanger T, Mutschelknauss E, Kropp S, Obi N, Vettorazzi E, Braendle W, Bastert G, Hentschel S, Berger J, Chang-Claude J (2008) Risk of different histological types of postmenopausal breast cancer by type and regimen of menopausal hormone therapy. Int J Cancer 123:933–941

    Article  CAS  PubMed  Google Scholar 

  7. Fournier A, Fabre A, Mesrine S, Boutron-Ruault MC, Berrino F, Clavel-Chapelon F (2008) Use of different postmenopausal hormone therapies and risk of histology- and hormone receptor-defined invasive breast cancer. J Clin Oncol 26:1260–1268

    Article  PubMed Central  PubMed  Google Scholar 

  8. Garcia-Closas M, Brinton LA, Lissowska J, Chatterjee N, Peplonska B, Anderson WF, Szeszenia-Dabrowska N, Bardin-Mikolajczak A, Zatonski W, Blair A, Kalaylioglu Z, Rymkiewicz G, Mazepa-Sikora D, Kordek R, Lukaszek S, Sherman ME (2006) Established breast cancer risk factors by clinically important tumour characteristics. Br J Cancer 95:123–129

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Kotsopoulos J, Chen WY, Gates MA, Tworoger SS, Hankinson SE, Rosner BA (2010) Risk factors for ductal and lobular breast cancer: results from the nurses’ health study. Breast Cancer Res 12:R106

    Article  PubMed Central  PubMed  Google Scholar 

  10. Li CI, Malone KE, Porter PL, Lawton TJ, Voigt LF, Cushing-Haugen KL, Lin MG, Yuan X, Daling JR (2008) Relationship between menopausal hormone therapy and risk of ductal, lobular, and ductal-lobular breast carcinomas. Cancer Epidemiol Biomarkers Prev 17:43–50

    Article  PubMed  Google Scholar 

  11. Li CI, Malone KE, Porter PL, Weiss NS, Tang MT, Cushing-Haugen KL, Daling JR (2003) Relationship between long durations and different regimens of hormone therapy and risk of breast cancer. JAMA 289:3254–3263

    Article  CAS  PubMed  Google Scholar 

  12. Li CI, Weiss NS, Stanford JL, Daling JR (2000) Hormone replacement therapy in relation to risk of lobular and ductal breast carcinoma in middle-aged women. Cancer 88:2570–2577

    Article  CAS  PubMed  Google Scholar 

  13. Newcomb PA, Titus-Ernstoff L, Egan KM, Trentham-Dietz A, Baron JA, Storer BE, Willett WC, Stampfer MJ (2002) Postmenopausal estrogen and progestin use in relation to breast cancer risk. Cancer Epidemiol Biomarkers Prev 11:593–600

    CAS  PubMed  Google Scholar 

  14. Newcomer LM, Newcomb PA, Potter JD, Yasui Y, Trentham-Dietz A, Storer BE, Longnecker MP, Baron JA, Daling JR (2003) Postmenopausal hormone therapy and risk of breast cancer by histologic type (United States). Cancer Causes Control 14:225–233

    Article  PubMed  Google Scholar 

  15. Reeves GK, Beral V, Green J, Gathani T, Bull D (2006) Hormonal therapy for menopause and breast-cancer risk by histological type: a cohort study and meta-analysis. Lancet Oncol 7:910–918

    Article  CAS  PubMed  Google Scholar 

  16. Rosenberg LU, Magnusson C, Lindstrom E, Wedren S, Hall P, Dickman PW (2006) Menopausal hormone therapy and other breast cancer risk factors in relation to the risk of different histological subtypes of breast cancer: a case-control study. Breast Cancer Res 8:R11

    Article  PubMed Central  PubMed  Google Scholar 

  17. Brinton LA, Richesson D, Leitzmann MF, Gierach GL, Schatzkin A, Mouw T, Hollenbeck AR, Lacey JV Jr (2008) Menopausal hormone therapy and breast cancer risk in the NIH-AARP Diet and Health Study Cohort. Cancer Epidemiol Biomarkers Prev 17:3150–3160

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Lee S, Kolonel L, Wilkens L, Wan P, Henderson B, Pike M (2006) Postmenopausal hormone therapy and breast cancer risk: the multiethnic cohort. Int J Cancer 118:1285–1291

    Article  CAS  PubMed  Google Scholar 

  19. Ursin G, Tseng CC, Paganini-Hill A, Enger S, Wan PC, Formenti S, Pike MC, Ross RK (2002) Does menopausal hormone replacement therapy interact with known factors to increase risk of breast cancer? J Clin Oncol 20:699–706

    Article  CAS  PubMed  Google Scholar 

  20. Wei F, Miglioretti DL, Connelly MT, Andrade SE, Newton KM, Hartsfield CL, Chan KA, Buist DS (2005) Changes in women’s use of hormones after the Women’s Health Initiative estrogen and progestin trial by race, education, and income. J Natl Cancer Inst Monogr 35:106–112

    Article  PubMed  Google Scholar 

  21. Waksberg J (1978) Sampling methods for random digit dialing. J Am Stat Assoc 73:40

    Article  Google Scholar 

  22. Voigt LF, Davis S, Heuser L (1992) Random digit dialing: the potential effect on sample characteristics of the conversion of nonresidential telephone numbers. Am J Epidemiol 136:1393–1399

    CAS  PubMed  Google Scholar 

  23. Begg CB, Gray R (1984) Calculation of polychotomous logistic regression parameters using individualized regressions. Biometrika 71:11–18

    Article  Google Scholar 

  24. Slanger TE, Chang-Claude JC, Obi N, Kropp S, Berger J, Vettorazzi E, Braendle W, Bastert G, Hentschel S, Flesch-Janys D (2009) Menopausal hormone therapy and risk of clinical breast cancer subtypes. Cancer Epidemiol Biomarkers Prev 18:1188–1196

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by the National Cancer Institute (R01-CA105041) and the Department of Defense (W81XWH-05-1-0482) (all authors).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Christopher I. Li, Janet R. Daling, Kara L. Haugen, Mei Tzu Chen Tang, Peggy L. Porter & Kathleen E. Malone

  2. Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Peggy L. Porter

Authors
  1. Christopher I. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janet R. Daling
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kara L. Haugen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mei Tzu Chen Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peggy L. Porter
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kathleen E. Malone
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher I. Li.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, C.I., Daling, J.R., Haugen, K.L. et al. Use of menopausal hormone therapy and risk of ductal and lobular breast cancer among women 55–74 years of age. Breast Cancer Res Treat 145, 481–489 (2014). https://doi.org/10.1007/s10549-014-2960-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-014-2960-4

Keywords

Search

Navigation