Systematic review about breast cancer incidence in relation to hormone replacement therapy use

Abstract

Background Several studies report a decrease in breast cancer incidence subsequent to the decrease in hormone replacement therapy (HRT) use. But its magnitude and the time-lag may vary between countries. This may reflect differences in populations, previous type and prevalence of HRT use and breast cancer screening.

Aim To review systematically studies assessing the relation between breast cancer incidence and change of HRT use.

Material and method Descriptive analysis of the methodology of the studies including design limitations and presence of confounding factors, data sources for breast cancer and HRT and regimens of HRT used.

Results and discussion Eighteen articles were selected. Most studies were ecological and confounding factors such as mammography screening and changes in reproductive and lifestyle habits could not be excluded. Sources of data on breast cancer and HRT were heterogeneous and only few data on HRT regimens used were available. Most studies concluded that the decrease in HRT use during the last decade was probably associated with a decrease in breast cancer incidence, especially for women aged 50 years or more.

Conclusions Data, mostly from epidemiological studies, suggest that the decrease in breast cancer incidence can be partly attributed to the drop in HRT use. Nevertheless, available studies are hampered by a number of limitations and it remains difficult to evaluate the exact impact of the drop in HRT use on the decrease in breast cancer incidence. Especially, the studies are seldom based on detailed individual data and do not provide information on regimens used, type of cancers and possible confounding factors.

Key words::

• HORMONE REPLACEMENT THERAPY
• MENOPAUSE HORMONE THERAPY
• BREAST CANCER
• INCIDENCE

ACKNOWLEDGEMENTS

We would like to thank the Vesalius Fund, the IRIS Research Fund and MSD for the unrestricted research grants they gave to Caroline Antoine, which permitted the conduct of this study.

Conflict of interest The authors have no conflict of interest to declare. The authors alone are responsible for the content and writing of this paper.

Source of funding Caroline Antoine and Serge Rozenberg received research funding from IRIS Research Fund, Vesalius Research Fund, Amgen and MSD.