Biomaterial Database

Estrogen replacement therapy and risk of fatal breast cancer in a prospective cohort of postmenopausal women in the United States. 1996

D B Willis, and E E Calle, and H L Miracle-McMahill, and C W Heath

Research Department, American Cancer Society, USA.

This study examines the relationship between fatal breast cancer and use of estrogen replacement therapy (ERT) among women in a large prospective study in the United States. After nine years of follow-up, 1,469 breast cancer deaths were observed in a cohort of 422,373 postmenopausal women who were cancer free at study entry and who supplied information on estrogen use. Results from Cox proportional hazards modeling, adjusted for 11 other potential risk factors, showed that ever-use of ERT was associated with a significantly decreased risk of fatal breast cancer (rate ratio [RR] = 0.84, 95 percent confidence interval [CI] = 0.75-0.94). There was a moderate trend (P = 0.07) of decreasing risk with younger age at first use of ERT. This decreased risk was most pronounced in women who experienced natural menopause before the age of 40 years (RR = 0.59, CI = 0.40-0.87). There was no discernible trend of increasing risk with duration of use in estrogen users at baseline or former users, nor was there any trend in years since last use in former users. The relationship between ERT and breast cancer mortality differed by age at menarche and by a self-reported history of breast cysts. No increased risk of fatal breast cancer with ERT was observed with estrogen use status (baseline/former), age at first use, duration of use, or years since last use. These findings suggest that ever-use of ERT is associated with a 16 percent decreased risk of fatal breast cancer.

UI	MeSH Term	Description	Entries
D007044	Hysterectomy	Excision of the uterus.	Hysterectomies
D008572	Menarche	The first MENSTRUAL CYCLE marked by the initiation of MENSTRUATION.
D008593	Menopause	The last menstrual period. Permanent cessation of menses (MENSTRUATION) is usually defined after 6 to 12 months of AMENORRHEA in a woman over 45 years of age. In the United States, menopause generally occurs in women between 48 and 55 years of age.	Change of Life, Female
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D001943	Breast Neoplasms	Tumors or cancer of the human BREAST.	Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D002423	Cause of Death	Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint.	Causes of Death,Death Cause,Death Causes
D005260	Female		Females
D005348	Fibrocystic Breast Disease	A common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including FIBROSIS, formation of CYSTS, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.	Breast Dysplasia,Fibrocystic Mastopathy,Mammary Dysplasia,Adenosis of Breast,Chronic Cystic Mastitis,Cystic Breast Disease,Cystic Disease of Breast,Fibrocystic Changes of Breast,Fibrocystic Disease of Breast,Microglandular Adenosis,Adenoses, Microglandular,Adenosis, Microglandular,Breast Adenosis,Breast Cystic Disease,Breast Cystic Diseases,Breast Disease, Cystic,Breast Disease, Fibrocystic,Breast Fibrocystic Change,Breast Fibrocystic Changes,Breast Fibrocystic Disease,Cystic Mastitis, Chronic,Disease, Cystic Breast,Disease, Fibrocystic Breast,Dysplasia, Breast,Dysplasia, Mammary,Mastopathy, Fibrocystic,Microglandular Adenoses
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup