title: A retrospective case-control study of the use of hormone-related supplements and association with breast cancer.
abstract: Hormone-related supplements (HRS), many of which contain phytoestrogens, are widely used to manage menopausal symptoms, yet their relationship with breast cancer risk has generally not been evaluated. We evaluated whether use of HRS was associated with breast cancer risk, using a population-based case-control study in 3 counties of the Philadelphia metropolitan area consisting of 949 breast cancer cases and 1,524 controls. Use of HRS varied significantly by race, with African American women being more likely than European American women to use any herbal preparation (19.2% vs. 14.7%, p=0.003) as well as specific preparations including black cohosh (5.4% vs. 2.0%, p=0.003), ginseng (12.5% vs. 7.9%, p<0.001) and red clover (4.7% vs. 0.6%, p<0.001). Use of black cohosh had a significant breast cancer protective effect (adjusted odds ratio 0.39, 95% CI: 0.22-0.70). This association was similar among women who reported use of either black cohosh or Remifemin (an herbal preparation derived from black cohosh; adjusted odds ratio 0.47, 95% CI: 0.27-0.82). The literature reports that black cohosh may be effective in treating menopausal symptoms, and has antiestrogenic, antiproliferative and antioxidant properties. Additional confirmatory studies are required to determine whether black cohosh could be used to prevent breast cancer.
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. trebbeck@cceb.med.upenn.edu
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Rebbeck
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.forename: Sandra
authors.initials: S
authors.lastname: Norman
authors.forename: Greta R
authors.initials: GR
authors.lastname: Bunin
authors.forename: Angela
authors.initials: A
authors.lastname: DeMichele
authors.forename: Mona
authors.initials: M
authors.lastname: Baumgarten
authors.forename: Michelle
authors.initials: M
authors.lastname: Berlin
authors.forename: Rita
authors.initials: R
authors.lastname: Schinnar
authors.forename: Brian L
authors.initials: BL
authors.lastname: Strom
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology* / Q000209:etiology; D016022:Case-Control Studies; D031885:Cimicifuga / Q000737:chemistry; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D048789:Phytoestrogens / Q000627:therapeutic use*; D008517:Phytotherapy; D010936:Plant Extracts / Q000737:chemistry; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data
chemical_list: D048789:Phytoestrogens; D010936:Plant Extracts; C073419:Remifemin