The Effect of Estrogen Plus Progestin Hormone Therapy on Breast Cancer Mortality: Still Unresolved
Menée sur une cohorte de 41 449 patientes ménopausées n'ayant pas subi d'hystérectomie et dont la mammographie de dépistage est négative, cette étude évalue l'incidence de cancer du sein (2 236 cas) et la mortalité spécifique en fonction de l'utilisation ou non d'un traitement hormonal substitutif associant œstrogènes et progestatif (25 328 cas et 16 121 témoins)
The article by Chlebowski et al. in this issue of the Journal (1) follows upon eight articles that have described the relationship between estrogen/progestin therapy and invasive breast cancer risk/mortality in studies from the Women’s Health Initiative (WHI) (2–9). Although a previous analysis addressed relationships between estrogen plus progestin use and breast cancer incidence among participants in the WHI Observational Study (WHIOS) (5), a cohort noted to have characteristics similar to participants in the WHI Randomized Trial (WHIRT), this is the first presentation of data from the WHIOS related to mortality outcomes. A major goal of the Chlebowski et al. study was to explore discrepancies between the randomized trial, which noted increased breast cancer mortality and adverse tumor characteristics associated with estrogen plus progestin therapy, and previous observational studies, which have mainly found usage to be associated with favorable prognosis breast cancers...