Impact of hormone replacement therapy on the histologic subtype of breast cancer.
OBJECTIVE
Postmenopausal hormone replacement therapy (HRT) is associated with an increase in breast cancer risk, which correlates to the duration of HRT use. We wanted to investigate a possible association between HRT use and the risk of a histologic subtype of breast cancer.


METHODS
From 1995 until 2004, 497 cases of primary ductal, lobular or ductulolobular breast cancer in postmenopausal women were diagnosed at the Department of Gynecology and Obstetrics, University Hospital Basel, Switzerland. The data was derived from patient's records. HRT ever use was defined as HRT use for > or =6 months.


RESULTS
Of the 99 cases of lobular cancer 72.7% were invasive lobular cancers, 21.2% were invasive ductulolobular cancers and 6.1% were lobular cancers in situ. Of the 398 cases of ductal cancer, 90.5% were invasive ductal cancers and 9.5% were ductal cancers in situ. Totally 144 women were HRT ever users, and 341 women were HRT never users. HRT status could not be defined in 12 women. HRT ever use was associated with an increased risk for lobular cancer (OR 1.67; 95% CI 1.02-2.73). Also, menopause due to bilateral oophorectomy was associated with an increased risk for lobular cancer (OR 2.42; 95% CI 1.06-5.54).


CONCLUSIONS
There is evidence that HRT as well as menopause due to bilateral oophorectomy may be associated with an increased risk for lobular cancer. This association is of major clinical relevance, since lobular breast cancer is more difficult to diagnose clinically and radiologically than ductal breast cancer.
Zanetti-Dällenbach
Rosanna A
RA
Department of Gynecology and Obstetrics, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland. rzanetti@uhbs.ch
Krause
Elke M
EM
Lapaire
Olav
O
Gueth
Uwe
U
Holzgreve
Wolfgang
W
Wight
Edward
E
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors