> Table 55: Postmenopausal hormones and recurrence after breast cancer diagnosis
This summary table contains detailed information about research studies. While viewing summary tables offers an informative glimpse at the science behind many breast cancer guidelines and recommendations, they should be viewed with some caution. There are a number of concepts you must understand to be able to successfully read and interpret research tables. To get some background information about understanding research tables, please see How to Read a Research Table.
|
Introduction: Because postmenopausal hormones have been shown to increase women’s risk of developing breast cancer, there has been concern that these hormones might also increase the risk of recurrence in women who have already had breast cancer. While much of the research done to date has yet to find such a link, one large randomized controlled trial showed a significant risk of recurrence in women using postmenopausal hormones after diagnosis compared to those who did not. At this time, breast cancer survivors, like most women, are generally advised to avoid long-term use of postmenopausal hormones.
Study selection criteria: Available randomized controlled trials, prospective cohort studies and pooled analyses.
Table Note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.
| |
Study
|
Study Population
(number of participants)
|
Follow-up
(months)
|
Relative Risk of Recurrence Among Women Who Used Postmenopausal Hormones after Breast Cancer Compared to Those Who Did Not,
RR (95% CI)
|
Randomized controlled trials
|
Holmberg et al. [1]
|
442
|
48
|
2.2 (1.0-5.1)
|
von Schoultz and Rutqvist [2]
|
378
|
49.2
|
0.82 (0.35-1.90)
|
Cohort studies
|
Dew et al. [3]
|
1472
|
87.6
|
0.24 (0.10-1.49)*
|
O'Meara et al. [4]
|
869
|
44
|
0.5 (0.3-0.85)
|
Vassilopoulou-Sellin et al. [5]
|
319
|
40
|
0.5 (0.1-3.8)
|
Durna et al. [6]
|
277
|
76
|
0.75 (0.29-1.95)†
|
Eden et al. [7]
|
270
|
24
|
0.4 (0.2-0.9)
|
Beckmann et al. [8]
|
185
|
32
|
0.7 (0.3-1.6)
|
Pooled analysis
|
Col et al. [9]
|
837
|
30
|
0.6 (0.4-1.2)
|
*Among women with estrogen receptor-positive breast cancer. This study also found a non-significant decrease in risk of recurrence among women with estrogen receptor-negative breast cancer and among women in this cohort using postmenopausal hormones and tamoxifen.
†Among women diagnosed with premenopausal breast cancer.
References
1. Holmberg L, Iverson OE, Rudenstam CM, et al., for the HABITS Study Group. Increased risk of recurrence after hormone replacement therapy in breast cancer survivors.J Natl Cancer Inst. 100(7):475-82, 2008.
2. von Schoultz E and Rutqvist LE on behalf of the Stockholm Breast Cancer Study Group. Menopausal hormone therapy after breast cancer: the Stockholm randomized trial. J Natl Cancer Inst. 97(7):533-5, 2005.
3. Dew JE, Wren BG, Eden JA. Tamoxifen, hormone receptors and hormone replacement therapy in women previously treated for breast cancer: a cohort study. Climacteric. 5(2):151-5, 2002.
4. O’Meara ES, Rossing MA, Daling JR, et al. Hormone replacement therapy after a diagnosis of breast cancer in relation to recurrence and mortality. J Natl Cancer Inst. 93:754-62, 2001.
5. Vassilopoulou-Sellin R, Asmar L, Hortobagyi GN, et al. Estrogen replacement therapy after localized breast cancer: clinical outcome of 319 women followed prospectively. J Clin Oncol. 17(5):1482-7, 1999.
6. Durna EM, Heller GZ, Leader LR, et al. Breast cancer in premenopausal women: recurrence and survival rates and relationship to hormone replacement therapy. Climacteric. 7(3):284-91, 2004.
7. Eden JA, Bush T, Nand S, et al. A case-control study of combined continuous estrogen-progestin replacement therapy among women with a personal history of breast cancer. Menopause J North Am Menopause Soc. 2:67-72, 1995.
8. Beckmann MW, Jap D, Djahansouzi S et al. Hormone replacement therapy after treatment of breast cancer: effects on postmenopausal symptoms, bone mineral density and recurrence rates. Oncology 60:199-206, 2001.
9. Col NF, Hirota LK, Orr RK, et al. Hormone replacement therapy after beast cancer: a systematic review and quantitative assessment of risk. J Clin Oncol. 19(8):2357-2363, 2001.
Updated 09/12/09
