How does the current or recent use of postmenopausal hormones affect a woman's risk for breast cancer?

Updated: Dec 26, 2019
  • Author: Graham A Colditz, MD, DrPH; Chief Editor: Chandandeep Nagi, MD  more...
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Data on recency of use have been sparse because many studies have not distinguished current from past users. One meta-analysis calculated a RR for current use of 1.63 for women with natural menopause and 1.48 for women with surgical menopause. In a second one, the summary RR was 1.40 (95% CI, 1.20-1.63) comparing current to never users. In the report from the Nurses' Health Study cohort, [43] an excess risk of breast cancer was limited to women with current or very recent use of postmenopausal hormones. In the Breast Cancer Detection Demonstration Project (BCDDP) cohort, a positive association with invasive breast cancer was noted among current users of 5-15 or more years’ duration.

These relationships were evaluated in considerable detail in the pooled analysis that combined results of 51 epidemiologic studies. [41] Importantly, in these analyses, women with an uncertain age at menopause were excluded (eg, women with simple hysterectomies), as inadequate accounting for age at menopause in the analysis can lead to substantial attenuation of the observed relationships between postmenopausal hormone use and breast cancer risk. The investigators observed a statistically significant association between current or recent use of postmenopausal hormones and risk of breast cancer; the positive association was strongest among those with the longest duration of use. No significant increase in breast cancer risk was noted for women who had quit using postmenopausal hormones 5 or more years in the past, regardless of their duration of use.

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