Download or read book Fatal Breast Cancer Risk in Relation to Use of Unopposed Estrogen and Combined Hormone Therapy written by and published by . This book was released on 2013 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: Use of combined menopausal hormone therapy (CHT) is associated with an increased risk of developing breast cancer, but it remains unclear to what degree the increase in incidence translates into an increase in breast cancer mortality. We evaluated fatal breast cancer risk in relation to recency and duration of use of CHT and unopposed estrogen hormone therapy (EHT). We conducted a large population-based nested case-control study in the Canadian province of Saskatchewan, where a population-based prescription drug database has existed since 1975. Cases (n = 1,288) were women who died of breast cancer in Saskatchewan between 1990-2008 at 50-79 years of age, and were eligible for Saskatchewan Prescription Drug Plan benefits for at least 5 years prior to their first primary breast cancer diagnosis (index date). Controls (n = 12,535) were matched to cases on duration of eligibility for health benefits prior to the index date and year of birth. Multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed using unconditional logistic regression. Exclusive use of EHT was not associated with risk of fatal breast cancer, neither overall nor within categories of recency and duration of use (OR for current use versus never use = 1.05; 95% CI: 0.83-1.34). Use of CHT (includes women who had also used EHT) was also not associated with fatal breast cancer risk (OR for current use versus never use = 0.93; 95% CI: 0.67-1.28), except for a suggestion of an increased risk associated with current long-term use. However, the number of women in this category of use was small and the confidence intervals wide. Consistent with several other studies, we observed no association between fatal breast cancer risk and use of EHT. Only a few studies have evaluated the association between fatal breast cancer risk and use of CHT, and collectively the results have been inconsistent. It remains to be seen whether women who take CHT are at an increased risk of dying from breast cancer.

Download or read book The Controversy over Hormone Replacement Therapy Evaluating Related Risk of Breast Cancer and Other Diseases written by and published by Am Cncl on Science, Health. This book was released on with total page 18 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Hormone Replacement Therapy and Breast Cancer written by Linda L. Humphrey and published by . This book was released on 2002 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: To evaluate and update the prior review evaluating the risk of breast cancer and breast cancer (BCA) death associated with the use of postmenopausal hormone replacement therapy (HRT) by reviewing the medical literature which has been published since the last US Preventive Services Task Force update. DATA SOURCE: All English language studies identified in the Medline database from 1992-2000 and all previously published meta-analyses. In addition, reference lists of key articles, letters, and editorials were reviewed for all related studies, including those pre-dating the database search. STUDY SELECTION: All studies that evaluated breast cancer incidence or mortality as a primary or secondary outcome in association with hormone replacement therapy published between 1992-2000. Studies evaluating the effect of hormone replacement therapy on breast density were also reviewed. DATA EXTRACTION: The following studies met inclusion criteria: 8 meta-analyses from the years 1988-1997, 1 nested case-control study, 14 case-control studies, and 15 cohort studies all evaluating breast cancer incidence, mortality, or both. Of the 15 cohort studies, 10 represented unique cohorts and of the 14 case control studies, 2 involved updates of the same case set. Data from each study were abstracted to prepared forms. When more than one study from the same population was reported, data from the most recent publication were reviewed. If data from the same population were analyzed by cohort and by case-control analysis, both results were reported if they evaluated different outcomes. In addition, several studies evaluating breast density and HRT were reviewed, and the best studies summarized. DATA SYNTHESIS: For ever or short-term use of estrogen, 7 of the 8 meta-analyses, 8 of the 11 case-control studies, and 6 of the 7 cohort studies evaluating incidence showed no increase in breast cancer with hormone replacement therapy. Of the original studies reviewed evaluating incidence, 12 of 19 showed no increased risk of breast cancer with long duration ERT or HRT use. However, 5 of the meta-analyses showed increased risk with duration over 5 years and 2 important cohort studies showed increased risk with longer duration use. Eleven original studies evaluated combined estrogen and progestin, and one showed increased risk of BCA with short-term use; 3 of the 5 evaluating duration with combined therapy showed increased risk that was statistically significant. Current use of ERT was associated with significantly increased risk of breast cancer in two of the best cohort studies; use of combined therapy was associated with increased risk in 3 studies. Six recent cohort studies (1992-2000) evaluated breast cancer mortality in association with hormone use: 1 showed increased risk of death, 4 showed decreased risk of death, and one showed no association. Several recent studies show that post-menopausal estrogen therapy is associated with increased breast density by mammography and that adding progesterone to estrogen results in even greater increases in breast density. Finally, there is evidence suggesting an important interaction between HRT and alcohol use and HRT and lower body weight. CONCLUSIONS: The association of short-term hormone replacement therapy with the development of breast cancer is uncertain based on multiple studies with inconsistent findings. Among studies indicating increased risk, the risk is largely confined to current and long-term use (>5-10 years), and the risk is relatively small (RR 1.2-1.5). Reduced mortality is a fairly consistent finding among the studies evaluating breast cancer mortality and HRT use. The addition of progesterone to estrogen and current, as well as long-term, use may be associated with breast cancer risk above that of estrogen itself. Although the biological plausibility of an association between postmenopausal hormone use and breast cancer is high, the studies showing risk or benefit from the use of post-menopausal hormones are limited by the observational nature of the epidemiologic data existing to date. Data from randomized controlled trials are needed to validly evaluate the relationship.

Download or read book The Controversy over Hormone Replacement Therapy written by and published by Am Cncl on Science, Health. This book was released on with total page 18 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Hormone Replacement Therapy and Breast Cancer written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-06-28 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this systematic evidence review, we evaluate data on the relationship between the use of postmenopausal hormone replacement therapy (HRT) and the risk of breast cancer (BCA). The context of this review is in the overall evaluation of postmenopausal hormone replacement therapy as chemoprophylaxis for chronic conditions. The results from this report will be used as part of an overall report on the risks and benefits of hormone replacement therapy for postmenopausal women. Hormone replacement therapy is used in the United States and worldwide to treat symptoms of menopause and to prevent chronic conditions such as osteoporosis. It is one of the most commonly prescribed drugs in the U.S.; a recent survey in the U.S. of postmenopausal women ages 50 to 75 showed that nearly 38% of women were currently using estrogen or hormone replacement therapy (58.7% of those with prior hysterectomy and 19.6% without hysterectomy). A major and as yet unanswered clinical question is whether hormone replacement therapy increases a woman's risk of breast cancer. This issue is a critical one because the use of HRT is prevalent and because breast cancer is a relatively common disease, so that even a small increase in breast cancer in association with hormone use could significantly influence public health. The importance of endogenous estrogen in the development of breast cancer has been evaluated and confirmed in multiple studies of differing methodologies. Studies in animals have shown that breast cancer can be induced by the administration of estrogen. Among humans, some studies have shown that women with increased levels of circulating estrogen are at higher risk for the subsequent development of breast cancer. Other studies have had conflicting findings, and some have shown this relationship in postmenopausal women only. Reproductive events are important risk factors for breast cancer. Those shown to increase risk include early menarche and late menopause, both of which prolong exposure to higher levels of estrogen as well as other reproductive hormones. Other reproductive experiences, such as late age at first pregnancy and nulliparity, increase breast cancer risk. Oopherectomy among premenopausal women is protective against breast cancer, possibly because of reduced exposure to estrogen. Other risk factors also suggest an important role for estrogen in BCA development. In postmenopausal women, obesity, which correlates with increased estrogen levels, is also associated with an increased risk of BCA. Recent studies have also shown that increased bone density, possibly a reflection of lifetime estrogen exposure, is associated with increased rates of breast cancer. Finally, age-adjusted rates of increase in breast cancer incidence slow at menopause when estrogen levels fall. There are several critical key questions to consider when evaluating the research describing the role of exogenous estrogen or estrogen/progesterone in breast cancer development and prognosis. First, is either estrogen alone or estrogen with progesterone associated with a change in breast cancer mortality? Second, does short-term estrogen use increase the risk of breast cancer? The third question, which is most relevant to the use of estrogen to prevent chronic conditions, is whether long-term estrogen increases breast cancer risk. The fourth question, which reflects the current standard of practice, is whether the combination of estrogen and progesterone, either short-term or long-term, increases the risk of breast cancer. Fifth, is current use of estrogen or hormone replacement therapy associated with increased risk of breast cancer? Sixth, are there subpopulations of women who might be at increased risk of breast cancer when using HRT? Finally, because increased breast mammographic density is independently associated with an increase in breast cancer risk, as well as with decreased accuracy of mammography, does estrogen or estrogen/progestins change breast density?

Download or read book Hormone Replacement Therapy and Breast Cancer Risk written by R.D. Mann and published by CRC Press. This book was released on 1992-07-15 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers a topic of considerable current interest and presents many of the most significant research findings available to date. Workers at the forefront of research on hormone replacement therapy and the implications for the risk of breast cancer were invited to attend a special Conference at the Royal Society of Medicine in London in September, 1991, where the latest data were presented to a distinguished audience and the implications of this research were discussed. The volume reviews various aspects of HRT and breast cancer, the physiology of the menopause, the current use of HRT in practice, osteoporosis and epidemiology and presents results from a range of European, American and Australian studies on the role of breast cancer and HRT, finishing with an overview of benefits, use and cost-effectiveness and a general summary. The book represents a definitive statement of current knowledge in this field and an informative update on the implications of recent research. It will be a valuable addition of special significance to the libraries of all those concerned with hormone replacement therapy and the study of breast cancer.

Download or read book Estrogen and Breast Cancer written by W. R. Miller and published by Landes Bioscience. This book was released on 1996 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Oestrogen Matters written by Dr Avrum Bluming and published by Hachette UK. This book was released on 2018-09-04 with total page 221 pages. Available in PDF, EPUB and Kindle. Book excerpt: 'I believe it is an ethical imperative for all clinicians who treat women in menopause or women with breast cancer to alert their patients to this book' Michael Baum, MD, Professor Emeritus of Surgery and visiting professor of Medical Humanities, University College London 'A thorough, careful and unbiased assessment . . . This extremely valuable message deserves to be widely disseminated' Lord Turnberg, former President of the Royal College of Physicians A compelling defence of hormone replacement therapy, exposing the faulty science behind its fall from prominence and empowering readers to make informed decisions about their health. For years, hormone replacement therapy (HRT) was hailed as a miracle. Study after study showed that HRT, if initiated at the onset of menopause, could ease symptoms ranging from hot flushes to memory loss; reduce the risk of heart disease, Alzheimer's, osteoporosis, and some cancers; and even extend a woman's overall life expectancy. But when a large study by the Women's Health Initiative announced results showing an uptick in breast cancer among women taking HRT, the winds shifted abruptly, and HRT, officially deemed a carcinogen, was abandoned. Now, sixteen years after HRT was left for dead, Dr Bluming, a medical oncologist, and Dr Tavris, a social psychologist, track its strange history and present a compelling case for its resurrection. They investigate what led the public - and much of the medical establishment - to accept the Women's Health Initiative's often exaggerated claims, while also providing a fuller picture of the science that supports HRT. A sobering and revelatory read, Oestrogen Matters sets the record straight on this beneficial treatment and provides an empowering path to wellness for women everywhere.

Download or read book Hormonally Active Agents in the Environment written by National Research Council and published by National Academies Press. This book was released on 2000-02-03 with total page 453 pages. Available in PDF, EPUB and Kindle. Book excerpt: Some investigators have hypothesized that estrogens and other hormonally active agents found in the environment might be involved in breast cancer increases and sperm count declines in humans as well as deformities and reproductive problems seen in wildlife. This book looks in detail at the science behind the ominous prospect of "estrogen mimics" threatening health and well-being, from the level of ecosystems and populations to individual people and animals. The committee identifies research needs and offers specific recommendations to decision-makers. This authoritative volume: Critically evaluates the literature on hormonally active agents in the environment and identifies known and suspected toxicologic mechanisms and effects of fish, wildlife, and humans. Examines whether and how exposure to hormonally active agents occursâ€"in diet, in pharmaceuticals, from industrial releases into the environmentâ€"and why the debate centers on estrogens. Identifies significant uncertainties, limitations of knowledge, and weaknesses in the scientific literature. The book presents a wealth of information and investigates a wide range of examples across the spectrum of life that might be related to these agents.

Download or read book Estrogen Replacement Therapy and Risk of Fatal Breast Cancer in a Prospective Cohort of Portmenopausal Women written by Dawn Butler Willis and published by . This book was released on 1995 with total page 154 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Hormonal Contraception and Post menopausal Hormonal Therapy written by IARC Working Group on the Evaluation of Carcinogenic Risks to Humans and published by World Health Organization. This book was released on 1999 with total page 692 pages. Available in PDF, EPUB and Kindle. Book excerpt: Evaluates evidence for an increased risk of cancer in women using combined oral contraceptives, progestogen-only hormonal contraceptives, post-menopausal estrogen therapy, and post-menopausal estrogen-progestogen therapy. Although the carcinogenicity of these preparations has been extensively investigated, the book stresses the many complex methodological issues that must be considered when interpreting findings and weighing results. Evidence of an association between use of these preparations and positive effects on health, including a reduced risk of some cancers, is also critically assessed. The first and most extensive monograph evaluates evidence of an association between the use of combined oral contraceptives and cancer at nine sites. Concerning breast cancer, the evaluation concludes that, even if the association is causal, the excess risk for breast cancer associated with patterns of use that are typical today is very small. Studies of predominantly high-dose preparations found an increased risk of hepatocellular carcinoma in the absence of hepatitis viruses. Citing these findings, the evaluation concludes that there is sufficient evidence in humans for the carcinogenicity of combined oral contraceptives. The evaluation also found sufficient evidence for the carcinogenicity of some, but not all, combined preparations in animals. Combined oral contraceptives were classified as carcinogenic to humans. The evaluation also cites conclusive evidence that these agents have a protective effect against cancers of the ovary and endometrium. Progestogen-only contraceptives are evaluated in the second monograph, which considers the association with cancer at six sites. The evaluation found no evidence of an increased risk for breast cancer. Although the evaluation found sufficient evidence in animals for the carcinogenicity of medroxyprogesterone acetate, evidence for the carcinogenicity of progestogen-only contraceptives in humans was judged inadequate. Progestogen-only contraceptives were classified as possibly carcinogenic to humans. The third monograph, on post-menopausal estrogen therapy, considers evidence of an association with cancer at eight sites. Findings from a large number of epidemiological studies indicate a small increase in the risk of breast cancer in women who have used these preparations for five years or more. Studies consistently show an association between use of post-menopausal estrogen therapy and an increased risk for endometrial cancer. Data on the association with other cancers were either inconclusive or suggested no effect on risk. The evaluation concludes that post-menopausal estrogen therapy is carcinogenic to humans. The final monograph evaluates the association between the use of post-menopausal estrogen-progestogen therapy and cancer at four sites. The evaluation of limited data on breast cancer found an increased relative risk observed with long-term use. Data were judged insufficient to assess the effects of past use and of different progestogen compounds, doses, and treatment schedules. For endometrial cancer, the evaluation found an increase in risk relative to non-users when the progestogen was added to the cycle for 10 days or fewer. Post-menopausal estrogen-progestogen therapy was classified as possibly carcinogenic to humans. Concerning post-menopausal therapy in general, the book notes that evidence of carcinogenic risks must be placed in perspective of potential benefits. The prevention of osteoporotic fractures is cited as the best-established benefit. Evidence also suggests that estrogen prevents heart disease and may prevent memory loss and dementia.

Download or read book Clinical Gynecology written by Eric J. Bieber and published by Cambridge University Press. This book was released on 2015-04-23 with total page 1127 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.

Download or read book Family History of Cancers Hormone Replacement Therapy and the Risk of Breast Cancer in Canada written by Margarita Parthimos and published by . This book was released on 2006 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent evidence of the effect of hormone replacement therapy (HRT) revealed an increased risk of postmenopausal breast cancer associated with the estrogen-progestin combination pill, though a decreased risk for exposure to estrogen alone. At the time of planning of this study, there was much inconsistency in findings from observational studies, explained, in part, by the differing estrogenic potencies over time, the introduction of progestin to estrogen therapies, and the examination of different time windows of exposure between studies. The impact of HRT may also differ by the family history of cancer, though this relationship has not been thoroughly studied. The objectives of this study were to determine whether a family history of different cancers, as measured by a family history score (FHS), and ever use of HRT use were associated with the risk for postmenopausal breast cancer, and whether there was evidence of an FHS-HRT interaction. Results indicate that HRT users were not at increased risk of postmenopausal breast cancer (OR=0.74, 95%CI: 0.52-1.05) compared to non-users. Relative to no family history of these cancers, women with a family history of cancer of the breast (OR=2.45, 95%CI: 1.37-4.36) and breast or ovary (OR=2.28, 95%CI: 1.35-3.85) were at increased risk of postmenopausal breast cancer. The FHS-HRT interaction was not statistically significant, however, analyses stratified by category of FHS (high, low, none) revealed a significant inverse effect of HRT use in women at highest risk for both a family history of cancer of the breast (OR=0.27, 95%CI: 0.10-0.71), and breast or ovary (OR=0.22, 95%CI: 0.09-0.53). These significant inverse associations are suggestive of a beneficial effect of HRT for women at highest risk based on their family history, and suggest estrogen as a viable alternative to prophylactic mastectomy and oophorectomy, as approximately 85% of HRT users reported exposure to estrogen alone. This requires further study. A case-control study nested within the Canadian National Breast Screening Study was conducted, with controls selected via incidence-density sampling at a case:control ratio of 4:1. Study participants (n=1,255) were stratified by menopausal status with only postmenopausal women (n=671 cases, 216 controls) included in the HRT and FHS-HRT interaction analyses.

Download or read book Diagnosis and Management of Ovarian Disorders written by Albert Altchek and published by Elsevier. This book was released on 2003-09-04 with total page 595 pages. Available in PDF, EPUB and Kindle. Book excerpt: This updated second edition of Diagnosis and Management of Ovarian Disorders provides thorough, yet succinct insight into the ever-changing realm of ovarian disorders. It presents a novel multidisciplinary approach to the subject as described by clinicians, surgeons, pathologists, basic scientists and related medical researchers. Topics covered include reproductive technology, early diagnosis of ovarian cancer, and management of menopause among others. The breadth of information provided by this book will appeal to clinicians and researchers involved in the study and treatment of ovarian disorders. KEY FEATURES* Includes updated information on early diagnosis of ovarian cancer* Reviews new diagnostic techniques for ovarian disorders* Discusses latest information on reproductive technology* Presents translational treatment linking laboratory research with clinical medicine

Download or read book Holland Frei Cancer Medicine written by Robert C. Bast, Jr. and published by John Wiley & Sons. This book was released on 2017-03-10 with total page 2004 pages. Available in PDF, EPUB and Kindle. Book excerpt: Holland-Frei Cancer Medicine, Ninth Edition, offers a balanced view of the most current knowledge of cancer science and clinical oncology practice. This all-new edition is the consummate reference source for medical oncologists, radiation oncologists, internists, surgical oncologists, and others who treat cancer patients. A translational perspective throughout, integrating cancer biology with cancer management providing an in depth understanding of the disease An emphasis on multidisciplinary, research-driven patient care to improve outcomes and optimal use of all appropriate therapies Cutting-edge coverage of personalized cancer care, including molecular diagnostics and therapeutics Concise, readable, clinically relevant text with algorithms, guidelines and insight into the use of both conventional and novel drugs Includes free access to the Wiley Digital Edition providing search across the book, the full reference list with web links, illustrations and photographs, and post-publication updates

Download or read book Textbook of Cancer Epidemiology written by Hans-Olov Adami and published by Oxford University Press. This book was released on 2008-02-27 with total page 783 pages. Available in PDF, EPUB and Kindle. Book excerpt: This superb text gives a concise, systematic account of what is currently known about the epidemiology and primary prevention for most forms of human cancer. Part 1 provides an introduction to basic concepts in epidemiology, a description of the global burden of cancer, definitions and characterizations of the various measures used, and approaches used to reveal genetic determinants of cancer risk and integrate biologic markers in the epidemiogic research process. Part 2 contains chapters of uniform structure on over 20 types of cancer, providing clinical and pathological outlines, descriptive epidemiology, and a comprehensive account of risk factors and their etiological importance. Specific sections address somatic and germ cell mutations that play a role in the occurrence of particular forms of cancer.

Download or read book MRCOG Part One written by Alison Fiander and published by Cambridge University Press. This book was released on 2016-10-13 with total page 557 pages. Available in PDF, EPUB and Kindle. Book excerpt: A fully updated and illustrated handbook providing comprehensive coverage of all curriculum areas covered by the MRCOG Part 1 examination.