Long-Term Use of Estrogen Hormone Therapy Linked to Higher Risk for Breast Cancer
In a landmark study, researchers have linked the long-term use of estrogen plus progesterone and estrogen-only hormone therapy with a higher risk for developing breast cancer.
“It’s already been confirmed that patients shouldn’t be undergoing estrogen plus progesterone hormone therapy (HT) for the long term,” said Wendy Y. Chen, M.D., M.P.H., associate physician at Brigham and Women’s Hospital and assistant professor in medicine at the Breast Cancer Oncology Center at the Dana-Farber Cancer Institute in Boston, Mass. “What we found is that people should also be careful about longer-term use of estrogen-alone HT.”
In previous studies, she said, researchers only evaluated risks associated with less than 10 years of HT use. Chen presented the findings at the AACR Annual Meeting 2012, held here March 31 - April 4.
Using data from the Nurses’ Health Study, the researchers evaluated follow-up data collected during 1980 through 2008 from postmenopausal female registered nurses who were aged 30 to 55 years old in 1976.
Chen and colleagues found that the risk for breast cancer, when compared with women who did not use HT, was 88 percent higher in women who had taken estrogen plus progesterone for 10 to 14.9 years; the risk increased more than twofold for women who used estrogen plus progesterone therapy for 15 to 19.9 years. For women who used estrogen-only HT, researchers found a 22 percent increased risk for breast cancer if used for 10 to 14.9 years and a 43 percent greater risk associated with 15 to 19.9 years of use.
Researchers also found that the risk did not plateau for either kind of HT. “There’s a continued effect over time. The longer you use it, the higher the risk,” said Chen.
Breast cancer Risk factors
A risk factor is anything that makes it more likely you’ll get a particular disease. But having one or even several risk factors doesn’t necessarily mean you’ll develop cancer — many women who develop breast cancer have no known risk factors other than simply being women.
Factors that are associated with an increased risk of breast cancer include:
Being female. Women are much more likely than men are to develop breast cancer.
Increasing age. Your risk of breast cancer increases as you age. Women older than 55 have a greater risk than do younger women.
A personal history of breast cancer. If you’ve had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.
A family history of breast cancer. If you have a mother, sister or daughter with breast cancer, you have a greater chance of being diagnosed with breast cancer. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most common gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don’t make cancer inevitable.
Radiation exposure. If you received radiation treatments to your chest as a child or young adult, you’re more likely to develop breast cancer later in life.
Obesity. Being overweight or obese increases your risk of breast cancer because fat tissue produces estrogen that may help fuel certain cancers.
Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
Beginning menopause at an older age. If you began menopause after age 55, you’re more likely to develop breast cancer.
Having your first child at an older age. Women who give birth to their first child after age 35 may have an increased risk of breast cancer.
Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer.
Drinking alcohol. Drinking alcohol increases the risk of breast cancer. Experts recommend no more than one alcoholic beverage a day for women.
Other risk factors that have been suggested, but don’t play any role in the development of breast cancer include tightfitting bras, antiperspirants, breast implants and shift work.
To further clarify long-term risks of estrogen-only therapy, the researchers evaluated a subset of the women who also met the requirements of participants in the Women’s Health Initiative trial, which is a randomized trial of postmenopausal women aged 50 years or older. Although the risk for breast cancer dipped slightly for women who used estrogen-only HT for less than 10 years, the risk increased 30 percent for women who took estrogen for 15 to 19.9 years.
HT did not increase the risk for fatal breast cancers.
“Even though we saw an increased risk in developing breast cancer, we did not see an increased risk for dying from breast cancer,” Chen said. She and her colleagues are currently researching this aspect of the findings.
This research was funded by the National Cancer Institute.
About the AACR
Founded in 1907, the American Association for Cancer Research (AACR) is the world’s first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR’s membership includes 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 18,000 attendees. In addition, the AACR publishes seven peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the Scientific Partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of individual and team science grants in cancer research that have the potential for patient benefit. The AACR actively communicates with legislators and policy makers about the value of cancer research and related biomedical science in saving lives from cancer.
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Source: American Association for Cancer Research (AACR)