title: Hormone Therapy and its Effect on the Prognosis in Breast Cancer Patients.
abstract: Introduction:Use of hormone therapy (HT) has declined dramatically in recent years. Some studies have reported that HT use before a diagnosis of breast cancer (BC) may be a prognostic factor in postmenopausal patients. This study aimed to examine the prognostic relevance of HT use before BC diagnosis.Methods:Four BC cohort studies in Germany were pooled, and 4492 postmenopausal patients with HT use data were identified. Patient data and tumor characteristics were compared between users and nonusers, along with overall survival (OS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS). Cox proportional hazards models were stratified by study center and adjusted for age at diagnosis, tumor stage, grading, nodal status, and hormone receptors.Results:Women with HT use before the diagnosis of BC were more likely to have a lower tumor stage, to be estrogen receptor-negative, and to have a lower grading. With regard to prognosis there were effects seen for OS, DMFS and LRFS, specifically in the subgroup of women with a positive hormone receptor. In these subgroups, BC patients had a better prognosis with previous HT use.Conclusions:HT use before a diagnosis of BC is associated with a more favorable prognosis in women with a positive hormone receptor status. It may be recommended that the prognostic factor HT should be documented and analyzed as a confounder for prognosis in studies of postmenopausal hormone-responsive breast cancers.
authors.affiliation: University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen.
authors.forename: C
authors.initials: C
authors.lastname: Rauh
authors.affiliation: Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital.
authors.forename: F
authors.initials: F
authors.lastname: Schuetz
authors.affiliation: Department of Gynecology and Obstetrics, Campus Innenstadt University Hospital, Ludwig Maximilian University, Munich.
authors.forename: B
authors.initials: B
authors.lastname: Rack
authors.affiliation: Department of Obstetrics and Gynecology, Freiburg University Medical Center, Freiburg.
authors.forename: E
authors.initials: E
authors.lastname: Stickeler
authors.affiliation: Department of Obstetrics and Gynecology, Freiburg University Medical Center, Freiburg.
authors.forename: M
authors.initials: M
authors.lastname: Klar
authors.affiliation: Institute of Pathology, Freiburg University Medical Center, Freiburg.
authors.forename: M
authors.initials: M
authors.lastname: Orlowska-Volk
authors.affiliation: Department of Radiology, Freiburg University Medical Center, Freiburg.
authors.forename: M
authors.initials: M
authors.lastname: Windfuhr-Blum
authors.affiliation: Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital.
authors.forename: J
authors.initials: J
authors.lastname: Heil
authors.affiliation: Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital.
authors.forename: J
authors.initials: J
authors.lastname: Rom
authors.affiliation: Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital.
authors.forename: C
authors.initials: C
authors.lastname: Sohn
authors.affiliation: Department of Gynecology and Obstetrics, Campus Innenstadt University Hospital, Ludwig Maximilian University, Munich.
authors.forename: U
authors.initials: U
authors.lastname: Andergassen
authors.affiliation: Department of Gynecology and Obstetrics, Campus Innenstadt University Hospital, Ludwig Maximilian University, Munich.
authors.forename: J
authors.initials: J
authors.lastname: Jueckstock
authors.affiliation: Department of Gynecology and Obstetrics, Duesseldorf University Hospital, Düsseldorf.
authors.forename: T
authors.initials: T
authors.lastname: Fehm
authors.affiliation: University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen.
authors.forename: C R
authors.initials: CR
authors.lastname: Loehberg
authors.affiliation: University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen.
authors.forename: A
authors.initials: A
authors.lastname: Hein
authors.affiliation: Institute of Diagnostic Radiology, University Breast Center, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen.
authors.forename: R
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.affiliation: Institute of Pathology, University Breast Center, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen.
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen.
authors.forename: M W
authors.initials: MW
authors.lastname: Beckmann
authors.affiliation: Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm.
authors.forename: W
authors.initials: W
authors.lastname: Janni
authors.affiliation: University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen ; Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Fasching
authors.affiliation: University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen ; Biostatistics Unit, Department of Gynecology and Obstetrics, Erlangen University Hospital, Erlangen.
authors.forename: L
authors.initials: L
authors.lastname: Häberle
keywords: breast cancer; hormone receptors; hormone therapy; prognosis