Hormonal manipulations and breast cancer.
Breast cancer is the most common cancer among women and the leading cause of death in women, 40 to 55 years of age. The lifetime odds of developing breast cancer are apparently up to 1 in 8 women in North America and 1 in 12 in Western Europe. According to the American Cancer Society, some 200,000 women (and 1,500 men) will be diagnosed with breast cancer this year. Although the incidence of breast cancer in women has been rising since the mid-1940s, the mortality has dropped modestly over the past decade, probably due to earlier and improved diagnosis and treatment. Evidence from both epidemiological and experimental studies points to an important role of reproductive variables in the development and promotion of human breast neoplasia. Hormonal manipulations, in the form of contraceptives, hormone replacement therapy, or antiestrogens, affect the incidence and course of breast cancer and may be useful in prevention and treatment of the tumor. In this review we summarize the current status of the use of hormones and antihormones in regard to breast cancer and outline possible areas of additional development and investigation.


BACKGROUND
Obstetricians and Gynecologists, Family Physicians.


OBJECTIVE
After completion of this article, the reader will be able to summarize the effects of estrogen and progestogens on the breast and to list the effects of other hormonal modulators on the breast.
Benshushan
Abraham
A
Lecturer in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, The Hebrew University, Hadassah Medical School, Jerusalem, Israel. benshushan@netscape.net
Brzezinski
Amnon
A
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D004967:Estrogens / Q000009:adverse effects*; D004968:Estrogens, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D007529:Isoflavones; D008550:Melatonin / Q000627:therapeutic use; D048789:Phytoestrogens; D028321:Plant Preparations; D011960:Receptors, Estrogen / Q000378:metabolism
D000970:Antineoplastic Agents; D003278:Contraceptives, Oral, Hormonal; D004967:Estrogens; D004968:Estrogens, Non-Steroidal; D007529:Isoflavones; D048789:Phytoestrogens; D028321:Plant Preparations; D011960:Receptors, Estrogen; D007987:Gonadotropin-Releasing Hormone; D008550:Melatonin