Does a better grade of tumour occurring in women under hormone replacement therapy compensate for their lower probability of detection by screening mammography.
OBJECTIVE
To compare the prognostic factor of breast cancer survival between breast cancer diagnosed in subjects receiving hormone replacement therapy (HRT) before diagnosis to those without such a therapy.


METHODS
All breast cancers diagnosed between 1993 and 2000 within the breast cancer screening programme in Bouches du Rhône (France) were analysed for size, node status, and grade according to use, or not, of HRT. Univariate and multivariate analyses were carried out taking into account age, density of the breast, and mode of detection.


RESULTS
The breast tumours diagnosed among HRT users had a lower grade whatever the mode of detection. The proportion of node positive tumours was identical in the two groups after adjustment for age. The smaller size of the tumours among HRT users is partly explained by the lower grade of these tumours Conclusion: Although tumours occurring in HRT users have a lower chance of being detected by screening, their prognostic factors, especially the grade of the tumour, are better than in non-users. More work is needed to find which part of this advantage is attributable to better surveillance of women treated with HRT
Centre Hospitalier Lyon-Sud, Service de biostatistiques, Bât 1M, 165 Chemin du Grand Revoyet, 69495 Pierre Benite, France.
J
J
Estève
B
B
Séradour
J
J
Jacquemier
L
L
Remontet
D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000187:drug effects; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging / Q000401:mortality*; D004967:Estrogens / Q000494:pharmacology; D005188:False Negative Reactions; D005260:Female; D005602:France / Q000453:epidemiology; D020249:Hormone Replacement Therapy; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D017698:Postmenopause; D011237:Predictive Value of Tests; D011374:Progesterone / Q000494:pharmacology; D011379:Prognosis; D012680:Sensitivity and Specificity
D004967:Estrogens; D011374:Progesterone