The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
The use of estrogens and progestins and the risk of breast cancer in postmenopausal women.
Open accessAbstract
BACKGROUND: The effect of adding progestins to estrogen therapy on the risk of breast cancer in postmenopausal women is controversial. METHODS: To quantify the relation between the use of hormones and the risk of breast cancer in postmenopausal women, we extended our follow-up of the participants in the Nurses' Health Study to 1992. The women were asked to complete questionnaires every two years to update information on their menopausal status, use of estrogen and progestin preparations, and any diagnosis of breast cancer. During 725,550 person-years of follow-up, we documented 1935 cases of newly diagnosed invasive breast cancer. RESULTS: The risk of breast cancer was significantly increased among women who were currently using estrogen alone (relative risk, 1.32; 95 percent confidence interval, 1.14 to 1.54) or estrogen plus progestin (relative risk, 1.41; 95 percent confidence interval, 1.15 to 1.74), as compared with postmenopausal women who had never used hormones. Women currently taking hormones who had used such therapy for 5 to 9 years had an adjusted relative risk of breast cancer of 1.46 (95 percent confidence interval, 1.22 to 1.74), as did those currently using hormones who had done so for a total of 10 or more years (relative risk, 1.46; 95 percent confidence interval, 1.20 to 1.76). The increased risk of breast cancer associated with five or more years of postmenopausal hormone therapy was greater among older women (relative risk for women 60 to 64 years old, 1.71; 95 percent confidence interval, 1.34 to 2.18). The relative risk of death due to breast cancer was 1.45 (95 percent confidence interval, 1.01 to 2.09) among women who had taken estrogen for five or more years. CONCLUSIONS: The addition of progestins to estrogen therapy does not reduce the risk of breast cancer among postmenopausal women. The substantial increase in the risk of breast cancer among older women who take hormones suggests that the trade-offs between risks and benefits should be carefully assessed.
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“recent data suggest that progestins exert a negative impact on breast cancer (2-5), with recent reports indicating an increased risk of the disease in women (6,7).”
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“The use of ERT requires the addition of progestins to counteract the endometrial proliferation induced by estrogens, whereas both estrogens and progestins could increase the risk of breast cancer (5,318).”
Citations
Cites
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793
Variations in mortality by weight among 750,000 men and women
Lew, E. A., & Garfinkel, L. (1979) · Journal of Chronic Diseases · doi:10.1016/0021-9681(79)90119-x · Cited by 1,169
Estrogens, Progestogens, Normal Breast Cell Proliferation, and Breast Cancer Risk
Pike, M. C., SPICER, D. V., Dahmoush, L., & Press, M. F. (1993) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a036102 · Cited by 1,009
TEST OF THE NATIONAL DEATH INDEX
Stampfer, M. J., Willett, W. C., Speizer, F. E., DYSERT, D. C., LIPNICK, R. J., ROSNER, B. A., & Hennekens, C. H. (1984) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113804 · Cited by 791
The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer
Key, T. J., & Pike, M. C. (1988) · European Journal of Cancer and Clinical Oncology · doi:10.1016/0277-5379(88)90173-3 · Cited by 658
The Risk of Breast Cancer after Estrogen and Estrogen–Progestin Replacement
Bergkvist, L., Adami, H., Persson, I. R., Hoover, R. N., & Schairer, C. (1989) · New England Journal of Medicine · doi:10.1056/nejm198908033210505 · Cited by 612
The Effect of Postmenopausal Estrogen Therapy on Bone Density in Elderly Women
Felson, D. T., Zhang, Y., Hannan, M. T., Kiel, D. P., Wilson, P. W. F., & Anderson, J. J. (1993) · New England Journal of Medicine · doi:10.1056/nejm199310143291601 · Cited by 580
THE EPIDEMIOLOGY OF SERUM SEX HORMONES IN POSTMENOPAUSAL WOMEN
Cauley, J. A., Gutai, J. P., Kuller, L. H., LEDONNE, D., & POWELL, J. G. (1989) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115234 · Cited by 485
Biologic Effects of Transdermal Estradiol
Chetkowski, R. J., Meldrum, D. R., Steingold, K. A., Randle, D., Lu, J. K., Eggena, P., Hershman, J. M., Alkjaersig, N. K., Fletcher, A. P., & Judd, H. L. (1986) · New England Journal of Medicine · doi:10.1056/nejm198606193142505 · Cited by 482
Biologic effects of transdermal estradiol
Chetkowski, R. J., Meldrum, D., & Ka, S. (1987) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(87)90325-0 · Cited by 467
Reproductive Risk Factors in a Prospective Study of Breast Cancer: The Nurses' Health Study
Rosner, B., Colditz, G. A., & Willett, W. C. (1994) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117079 · Cited by 372
HUNT, K., Vessey, M. P., McPherson, K., & Coleman, M. P. (1987) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1987.tb03166.x · Cited by 288
Tretli, S. (1989) · International Journal of Cancer · doi:10.1002/ijc.2910440105 · Cited by 284
Menopausal oestrogens and breast cancer risk: An expanded case-control study
Brinton, L. A., Hoover, R. N., & Fraumeni, J. F. (1986) · British Journal of Cancer · doi:10.1038/bjc.1986.246 · Cited by 253
Hormone replacement therapy and risk of breast cancer: Results from epidemiologic studies
Colditz, G. A., Egan, K. M., & Stampfer, M. J. (1993) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(11)90784-4 · Cited by 247
Prospective Study of Relative Weight, Height, and Risk of Breast Cancer
London, S. J. (1989) · JAMA · doi:10.1001/jama.1989.03430200097033 · Cited by 234
Breast Cancer and Artificial Menopause: A Cohort Study 2
Feinleib, M. (1968) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/41.2.315 · Cited by 189
Decreased incidence of breast cancer in postmenopausal estrogen-progestogen users.
Rd, G., Rc, M., & Bi, S. (1983) · PubMed · Cited by 187
The Risk of Breast Cancer in Postmenopausal Women Who Have Used Estrogen Replacement Therapy
Wingo, P. A. (1987) · JAMA · doi:10.1001/jama.1987.03390020075030 · Cited by 185
Prospective Study of Oral Contraceptive Use and Risk of Breast Cancer in Women
Romieu, I., Willett, W. C., Colditz, G. A., Stampfer, M. J., ROSNER, B. A., Hennekens, C. H., & Speizer, F. E. (1989) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/81.17.1313 · Cited by 145
The relationship of cancer of the female breast to artificial menopause and marital status
Lilienfeld, A. M. (1956) · Cancer · doi:10.1002/1097-0142(195609/10)9:5 · Cited by 143
Colditz, G. A., Stampfer, M. J., Willett, W. C., Hunter, D. J., Manson, J. E., Hennekens, C. H., ROSNER, B. A., & Speizer, F. E. (1992) · Cancer Causes & Control · doi:10.1007/bf00051356 · Cited by 124
Kaufman, D. W., Palmer, J. R., de Mouzon, J., Rosenberg, L. A., Stolley, P. D., Warshauer, M. E., Zauber, A. G., & Shapiro, S. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116041 · Cited by 112
Breast Cancer Risk after Estrogen Replacement Therapy: Results from the Toronto Breast Cancer Study
Palmer, J. R., Rosenberg, L. A., Clarke, E. A., Miller, D. R., & Shapiro, S. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116042 · Cited by 102
The effects of oestrogens and progestogens on the postmenopausal endometrium
Whitehead, M. I. (1978) · Maturitas · doi:10.1016/0378-5122(78)90015-4 · Cited by 93
The Waning Effect of Postmenopausal Estrogen Therapy on Osteoporosis
Ettinger, B. B., & Grady, D. G. (1993) · New England Journal of Medicine · doi:10.1056/nejm199310143291610 · Cited by 73
Noncontraceptive hormone use and risk of breast cancer
Yang, C. P., Daling, J. R., Band, P. R., Gallagher, R. P., White, E., & Weiss, N. S. (1992) · Cancer Causes & Control · doi:10.1007/bf00051360 · Cited by 66
Ovarian cancer incidence and mortality in denmark, 1943‐1982
Ewertz, M., & Kjær, S. K. (1988) · International Journal of Cancer · doi:10.1002/ijc.2910420510 · Cited by 64
Exogenous Progestins and Breast Cancer
Stanford, J. L., & Thomas, D. B. (1993) · Epidemiologic Reviews · doi:10.1093/oxfordjournals.epirev.a036120 · Cited by 55
Prospective study of relative weight, height, and risk of breast cancer
London, S. J. (1989) · JAMA · doi:10.1001/jama.262.20.2853 · Cited by 46
Jurgens, R. W., Downey, L. J., Abernethy, W. D., Cutler, N. R., & Conrad, J. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(11)91429-x · Cited by 37
SEQUENTIAL PATHOGENIC COMPONENTS OF RATES
Morrison, A. S. (1979) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112734 · Cited by 32
The risk of breast cancer in postmenopausal women who have used estrogen replacement therapy
Wingo, P. A. (1987) · JAMA · doi:10.1001/jama.257.2.209 · Cited by 27
Effect of treatment with estrogen conjugates on endogenous plasma steroids.
Rose, D. P., Fern, M., Liskowski, L., & Milbrath, J. R. (1977) · PubMed · Cited by 18
Research works printed but not linked: 4
- Feinleib M, 1968, J Natl Cancer Inst, 41, 315
- Committee on the relationship Between Oral Contraceptives and Breast Cancer, Institute of Medicine. Oral contraceptives & breast cancer. Washington, D.C.: National Academy Press, 1991.
- Gambrell RD, 1983, Obstet Gynecol, 62, 435
- Rose DP, 1977, Obstet Gynecol, 49, 80
Cited by
Sorted by citations
Writing Group for the Women's Health Initiative Investigators (2002) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.288.3.321 · Cited by 15,889
Design of the Women’s Health Initiative Clinical Trial and Observational Study
The Women’s Health Initiative Study Group (1998) · Controlled Clinical Trials · doi:10.1016/s0197-2456(97)00078-0 · Cited by 2,580
Calle, E. E., Heath Jr., C. W., Coates, R. J., Liff, J. M., Franceschi, S., Talamini, R., Chantarakul, N., Koetsawang, S., Rachawat, D., Morabia, A., et al. (1997) · The Lancet · doi:10.1016/s0140-6736(97)08233-0 · Cited by 2,450
ACC/AHA guidelines for the management of patients with acute myocardial infarction
Ryan, T. J., Anderson, J. L., Antman, E. M., Braniff, B. A., Brooks, N. H., Califf, R. M., Hillis, L. D., Hiratzka, L. F., Rapaport, E., Riegel, B. J., et al. (1996) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(96)00392-0 · Cited by 1,962
Chlebowski, R. T., Hendrix, S. L., Langer, R. D., Stefanick, M. L., Gass, M. L. S., Lane, D. S., Rodabough, R. J., Gilligan, M. A., Cyr, M. G., Thomson, C. A., et al. (2003) · JAMA · doi:10.1001/jama.289.24.3243 · Cited by 1,871
Metadata
- Authors
- Colditz, G. A., Hankinson, S. E., Hunter, D. J., Willett, W. C., Manson, J. E., Stampfer, M. J., Hennekens, C., Rosner, B., & Speizer, F. E.
- Affiliations
- Brigham and Women's Hospital (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1995-06-15
- Volume
- 332
- Issue
- 24
- Pages
- 1589-1593
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2607238143
- Cited by
- 1,487
- References
- 32
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 8 · 2022: 8 · 2021: 13 · 2020: 13 · 2019: 11 · 2018: 17 · 2017: 16 · 2016: 16 · 2015: 18 · 2014: 21 · 2013: 18 · 2012: 26
- FWCI
- 111.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (CA 40956)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- breast cancer risk, hormone replacement therapy, estrogen therapy, progestins, estrogen plus progestin, duration of hormone use, age-related risk, breast cancer mortality, Nurses' Health Study
- MeSH terms
- Aged, Breast Neoplasms, Estrogens, Female, Follow-Up Studies, Humans, Middle Aged, Progestins, Prospective Studies, Risk, Risk Factors, Cohort Studies, Estrogen Replacement Therapy, Confidence Intervals, Case-Control Studies, Postmenopause
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