title: The impact of hormone replacement therapy on the detection and stage of breast cancer.
abstract: OBJECTIVE
  Patients who receive hormone replacement therapy (HRT) and subsequently develop breast cancer are more likely to be diagnosed by palpation than mammography and have a higher stage of cancer at initial diagnosis.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Two hundred ninety-two patients with breast cancer who were postmenopausal.
  
  
  METHODS
  Clinical examination, mammography, and definitive therapy.
  
  
  METHODS
  Hormone replacement therapy use, mode of cancer detection, tumor size, nodal status, stage, and survival.
  
  
  RESULTS
  Patients receiving HRT prior to diagnosis had significantly more incidences of mammographically detected tumors, ductal carcinoma in situ, T1 lesions, negative nodes, and better survival rates than nonusers.
  
  
  CONCLUSIONS
  A history of HRT use had only beneficial and no discernible adverse effects on breast cancer detection and outcomes. These effects of HRT seem to be due to the development of less aggressive tumors rather than earlier detection.
authors.affiliation: Department of General Surgery, Oregon Health and Sciences University Portland, OR, USA. pommierr@ohsu.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Cheek
authors.forename: Judith
authors.initials: J
authors.lastname: Lacy
authors.forename: SuEllen
authors.initials: S
authors.lastname: Toth-Fejel
authors.forename: Katherine
authors.initials: K
authors.lastname: Morris
authors.forename: Kristine
authors.initials: K
authors.lastname: Calhoun
authors.forename: Rodney F
authors.initials: RF
authors.lastname: Pommier
mesh_terms: D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D008327:Mammography; D009367:Neoplasm Staging; D010173:Palpation; D017698:Postmenopause; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors