The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer

Thomas A. Sellers, Pamela J. Mink, James R. Cerhan, Wei Zheng, Kristin E. Anderson, Lawrence H. Kushi, Aaron R. Folsom

Research output: Contribution to journalArticle

167 Citations (Scopus)

Abstract

Background: The risks and benefits of hormone replacement therapy (HRT) are of considerable interest and importance, especially in terms of whether they differ among subsets of women. Objective: To determine whether HRT is associated with increased risks for breast cancer and total mortality in women with a family history of breast cancer. Design: Prospective cohort study. Setting: Population-based sample of midwestern postmenopausal women enrolled in an observational study of risk factors for cancer. Participants: Random sample of 41 837 female Iowa residents 55 to 69 years of age. Measurements: Incidence rates of and relative risks for breast cancer (n = 1085) and total mortality (n = 2035) through 8 years of follow-up were calculated by using data from the State Health Registry of Iowa and the National Death Index. Results: A family history of breast cancer was reported by 12.2% of the cohort at risk. Among women with a family history of breast cancer, those who currently used HRT and had done so for at least 5 years developed breast cancer at an age-adjusted annual rate of 61 cases per 10 000 person-years (95% CI, 28 to 94 cases); this rate was not statistically significantly big her than the rate in women who had never used HRT (46 cases per 10 000 person-years [CI, 36 to 55 cases]). Among women with a family history, those who used HRT had a significantly lower risk for total mortality than did women who had never used HRT (relative risk, 0.67 [CI, 0.51 to 0.89]), including total cancer-related mortality (relative risk, 0.75 [CI, 0.50 to 1.12]). The age-adjusted annual mortality rate for women using HRT for at least 5 years was 46 deaths per 10 000 person-years (CI, 19 to 74 deaths); this is roughly half the rate seen in women who had never used HRT (80 deaths per 10 000 person-years [CI, 69 to 92 deaths]). Conclusions: These data suggest that HRT use in women with a family history of breast cancer is not associated with a significantly increased incidence of breast cancer but is associated with a significantly reduced total mortality rate.

Original languageEnglish (US)
Pages (from-to)973-980
Number of pages8
JournalAnnals of Internal Medicine
Volume127
Issue number11
StatePublished - Dec 1 1997
Externally publishedYes

Fingerprint

Hormone Replacement Therapy
Breast Neoplasms
Mortality
Incidence
Observational Studies
Registries
Neoplasms
Cohort Studies
Prospective Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sellers, T. A., Mink, P. J., Cerhan, J. R., Zheng, W., Anderson, K. E., Kushi, L. H., & Folsom, A. R. (1997). The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer. Annals of Internal Medicine, 127(11), 973-980.

The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer. / Sellers, Thomas A.; Mink, Pamela J.; Cerhan, James R.; Zheng, Wei; Anderson, Kristin E.; Kushi, Lawrence H.; Folsom, Aaron R.

In: Annals of Internal Medicine, Vol. 127, No. 11, 01.12.1997, p. 973-980.

Research output: Contribution to journalArticle

Sellers, TA, Mink, PJ, Cerhan, JR, Zheng, W, Anderson, KE, Kushi, LH & Folsom, AR 1997, 'The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer', Annals of Internal Medicine, vol. 127, no. 11, pp. 973-980.
Sellers, Thomas A. ; Mink, Pamela J. ; Cerhan, James R. ; Zheng, Wei ; Anderson, Kristin E. ; Kushi, Lawrence H. ; Folsom, Aaron R. / The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer. In: Annals of Internal Medicine. 1997 ; Vol. 127, No. 11. pp. 973-980.
@article{36ff48d41bab4a4482fb303e01ba7f37,
title = "The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer",
abstract = "Background: The risks and benefits of hormone replacement therapy (HRT) are of considerable interest and importance, especially in terms of whether they differ among subsets of women. Objective: To determine whether HRT is associated with increased risks for breast cancer and total mortality in women with a family history of breast cancer. Design: Prospective cohort study. Setting: Population-based sample of midwestern postmenopausal women enrolled in an observational study of risk factors for cancer. Participants: Random sample of 41 837 female Iowa residents 55 to 69 years of age. Measurements: Incidence rates of and relative risks for breast cancer (n = 1085) and total mortality (n = 2035) through 8 years of follow-up were calculated by using data from the State Health Registry of Iowa and the National Death Index. Results: A family history of breast cancer was reported by 12.2{\%} of the cohort at risk. Among women with a family history of breast cancer, those who currently used HRT and had done so for at least 5 years developed breast cancer at an age-adjusted annual rate of 61 cases per 10 000 person-years (95{\%} CI, 28 to 94 cases); this rate was not statistically significantly big her than the rate in women who had never used HRT (46 cases per 10 000 person-years [CI, 36 to 55 cases]). Among women with a family history, those who used HRT had a significantly lower risk for total mortality than did women who had never used HRT (relative risk, 0.67 [CI, 0.51 to 0.89]), including total cancer-related mortality (relative risk, 0.75 [CI, 0.50 to 1.12]). The age-adjusted annual mortality rate for women using HRT for at least 5 years was 46 deaths per 10 000 person-years (CI, 19 to 74 deaths); this is roughly half the rate seen in women who had never used HRT (80 deaths per 10 000 person-years [CI, 69 to 92 deaths]). Conclusions: These data suggest that HRT use in women with a family history of breast cancer is not associated with a significantly increased incidence of breast cancer but is associated with a significantly reduced total mortality rate.",
author = "Sellers, {Thomas A.} and Mink, {Pamela J.} and Cerhan, {James R.} and Wei Zheng and Anderson, {Kristin E.} and Kushi, {Lawrence H.} and Folsom, {Aaron R.}",
year = "1997",
month = "12",
day = "1",
language = "English (US)",
volume = "127",
pages = "973--980",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "11",

}

TY - JOUR

T1 - The role of hormone replacement therapy in the risk for breast cancer and total mortality in women with a family history of breast cancer

AU - Sellers, Thomas A.

AU - Mink, Pamela J.

AU - Cerhan, James R.

AU - Zheng, Wei

AU - Anderson, Kristin E.

AU - Kushi, Lawrence H.

AU - Folsom, Aaron R.

PY - 1997/12/1

Y1 - 1997/12/1

N2 - Background: The risks and benefits of hormone replacement therapy (HRT) are of considerable interest and importance, especially in terms of whether they differ among subsets of women. Objective: To determine whether HRT is associated with increased risks for breast cancer and total mortality in women with a family history of breast cancer. Design: Prospective cohort study. Setting: Population-based sample of midwestern postmenopausal women enrolled in an observational study of risk factors for cancer. Participants: Random sample of 41 837 female Iowa residents 55 to 69 years of age. Measurements: Incidence rates of and relative risks for breast cancer (n = 1085) and total mortality (n = 2035) through 8 years of follow-up were calculated by using data from the State Health Registry of Iowa and the National Death Index. Results: A family history of breast cancer was reported by 12.2% of the cohort at risk. Among women with a family history of breast cancer, those who currently used HRT and had done so for at least 5 years developed breast cancer at an age-adjusted annual rate of 61 cases per 10 000 person-years (95% CI, 28 to 94 cases); this rate was not statistically significantly big her than the rate in women who had never used HRT (46 cases per 10 000 person-years [CI, 36 to 55 cases]). Among women with a family history, those who used HRT had a significantly lower risk for total mortality than did women who had never used HRT (relative risk, 0.67 [CI, 0.51 to 0.89]), including total cancer-related mortality (relative risk, 0.75 [CI, 0.50 to 1.12]). The age-adjusted annual mortality rate for women using HRT for at least 5 years was 46 deaths per 10 000 person-years (CI, 19 to 74 deaths); this is roughly half the rate seen in women who had never used HRT (80 deaths per 10 000 person-years [CI, 69 to 92 deaths]). Conclusions: These data suggest that HRT use in women with a family history of breast cancer is not associated with a significantly increased incidence of breast cancer but is associated with a significantly reduced total mortality rate.

AB - Background: The risks and benefits of hormone replacement therapy (HRT) are of considerable interest and importance, especially in terms of whether they differ among subsets of women. Objective: To determine whether HRT is associated with increased risks for breast cancer and total mortality in women with a family history of breast cancer. Design: Prospective cohort study. Setting: Population-based sample of midwestern postmenopausal women enrolled in an observational study of risk factors for cancer. Participants: Random sample of 41 837 female Iowa residents 55 to 69 years of age. Measurements: Incidence rates of and relative risks for breast cancer (n = 1085) and total mortality (n = 2035) through 8 years of follow-up were calculated by using data from the State Health Registry of Iowa and the National Death Index. Results: A family history of breast cancer was reported by 12.2% of the cohort at risk. Among women with a family history of breast cancer, those who currently used HRT and had done so for at least 5 years developed breast cancer at an age-adjusted annual rate of 61 cases per 10 000 person-years (95% CI, 28 to 94 cases); this rate was not statistically significantly big her than the rate in women who had never used HRT (46 cases per 10 000 person-years [CI, 36 to 55 cases]). Among women with a family history, those who used HRT had a significantly lower risk for total mortality than did women who had never used HRT (relative risk, 0.67 [CI, 0.51 to 0.89]), including total cancer-related mortality (relative risk, 0.75 [CI, 0.50 to 1.12]). The age-adjusted annual mortality rate for women using HRT for at least 5 years was 46 deaths per 10 000 person-years (CI, 19 to 74 deaths); this is roughly half the rate seen in women who had never used HRT (80 deaths per 10 000 person-years [CI, 69 to 92 deaths]). Conclusions: These data suggest that HRT use in women with a family history of breast cancer is not associated with a significantly increased incidence of breast cancer but is associated with a significantly reduced total mortality rate.

UR - http://www.scopus.com/inward/record.url?scp=0030667719&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030667719&partnerID=8YFLogxK

M3 - Article

C2 - 9412302

AN - SCOPUS:0030667719

VL - 127

SP - 973

EP - 980

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 11

ER -