Abstract
Objectives
The association between pre-diagnostic hormone replacement therapy (HRT) and breast
cancer specific mortality as well as potential influences from other lifestyle factors
on the association was investigated.
Study design
Female participants from the prospective cohort “Diet, Cancer, and Health” diagnosed
with breast cancer (BC) were identified and their pre-diagnostic HRT use evaluated
for association with tumour biology and breast cancer outcome in multivariate analysis.
Main outcome measure
Breast cancer specific mortality.
Results
Of the 1212 patients originally considered 1064 were included. Of these, 105 women
died from breast cancer during a median follow-up of 6.3 years (range 0.2–14.3 years).
In multivariate analyses women who used HRT at enrolment into the cohort study had
47% lower risk of dying from breast cancer as compared to women who had previously
or never used HRT (adjusted HR: 0.53; 95% CI, 0.37–0.85). Pre-diagnostic HRT use was
associated with smaller tumour size at the time of diagnosis and a higher frequency
of receptor positive breast cancer. Paradoxically, a high pre-diagnostic intake of
vitamin D supplements was associated with HRT use but also with a higher BC specific
mortality (HR: 1.47; 95% CI, 1.07–2.00)
Conclusions
HRT use at enrolment was associated with breast tumours of smaller size at the time
of diagnosis and positive receptor status, and with a lower BC mortality. The found
association between vitamin D from supplements and higher BC mortality warrants further
exploration.
Keywords
Abbreviations:
HRT (hormone replacement therapy), BMI (body mass index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 20, 2014
Accepted:
September 15,
2014
Received:
August 15,
2014
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
