title: Postmenopausal hormone replacement therapy: effect on diagnosis and outcome in early-stage invasive breast cancer treated with conservative surgery and radiation.
abstract: OBJECTIVE
  To compare the pretreatment characteristics and outcome of postmenopausal women with stage I-II breast cancer treated with conservative surgery and radiation who had a history of hormone replacement therapy (HRT) with those who had never received HRT.
  
  
  METHODS
  From 1979 to 1993, 485 postmenopausal women underwent excisional biopsy, axillary dissection, and radiation for stage I-II breast cancer. The median follow-up was 5.9 years. One hundred forty-one patients reported a history of HRT. The median length of use was 5 years. Three hundred forty-four patients reported no history of HRT.
  
  
  RESULTS
  Statistically significant differences between the two groups were observed for median age (HRT 60 years v no HRT 64 years; P =.0009), median weight (HRT 142 lbs v no HRT 152 lbs; P =.004), clinical tumor size < or = 2 cm (HRT 77% v no HRT 66%; P =.02), and the use of re-excision (HRT 62% v no HRT 49%; P =.01). The method of detection by mammogram only (HRT 52% v no HRT 42%; P =.06) was of borderline statistical significance. The HRT patients had a statistically significant increased cumulative incidence of ipsilateral breast tumor recurrence (8% v 2%; P =.02), a statistically significant decreased cumulative incidence of distant metastases (HRT 6% v no HRT 17%; P =.01), and a borderline statistically significant improvement in cause-specific survival at 10 years (HRT 92% v no HRT 86%; P =.07). Postmenopausal women with a history of HRT did not have an increased risk of contralateral breast cancer or second non-breast cancer malignancy.
  
  
  CONCLUSIONS
  This study failed to identify an adverse effect of HRT on breast cancer mortality in patients with stage I-II disease treated with conservative surgery and radiation.
authors.affiliation: Division of Population Science, Department of Biostatistics, and Departments of Radiation Oncology, Radiology, Pathology, and Surgery, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. b_fowble@fccc.edu
authors.forename: B
authors.initials: B
authors.lastname: Fowble
authors.forename: A
authors.initials: A
authors.lastname: Hanlon
authors.forename: G
authors.initials: G
authors.lastname: Freedman
authors.forename: A
authors.initials: A
authors.lastname: Patchefsky
authors.forename: H
authors.initials: H
authors.lastname: Kessler
authors.forename: N
authors.initials: N
authors.lastname: Nicolaou
authors.forename: J
authors.initials: J
authors.lastname: Hoffman
authors.forename: E
authors.initials: E
authors.lastname: Sigurdson
authors.forename: M
authors.initials: M
authors.lastname: Boraas
authors.forename: L
authors.initials: L
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012008:Recurrence; D018570:Risk Assessment; D015996:Survival Rate