title: Hormone replacement therapy after menopause and risk of breast cancer in BRCA1 mutation carriers: a case-control study.
abstract: Many BRCA1 mutation carriers undergo elective surgical oophorectomy (often before menopause) to manage their elevated risk of developing ovarian cancer. It is important to clarify whether or not the use of hormone replacement therapy (HRT) to mitigate the symptoms associated with surgical or natural menopause is safe in women with an inherited BRCA1 mutation and no personal history of breast or ovarian cancer. We conducted a case-control analysis of 432 matched pairs of women with a BRCA1 mutation. Detailed information on HRT use after menopause (duration, type, age at first/last use, formulation) was obtained from a research questionnaire administered at the time of study enrollment. Conditional logistic regression was used to estimate the odds ratio (OR) and 95 % confidence intervals (CI) associated with HRT use. The mean duration of HRT use after menopause was 4.3 years among the cases and 4.4 years among the controls (P = 0.83). The adjusted OR for breast cancer comparing all women who ever used HRT to those who never used HRT was 0.80 (95 % CI 0.55-1.16; P = 0.24). Findings did not differ by type of menopause (natural vs. surgical), by recency of use, by duration of use, and by formulation type. These findings suggest that a short course of HRT should not be contra-indicated for BRCA1 mutation carriers who have undergone menopause and who have no personal history of cancer.
authors.affiliation: Women's College Research Institute, Women's College Hospital, 76 Grenville Street, 6th Floor, Toronto, ON, M5S 1B2, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Kotsopoulos
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Huzarski
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Gronwald
authors.affiliation: Inherited Cancer Research Group, Department for Medical Genetics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.|Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
authors.forename: Pal
authors.initials: P
authors.lastname: Moller
authors.affiliation: Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE, USA.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Lynch
authors.affiliation: Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Neuhausen
authors.affiliation: Division of Human Genetics, The Ohio State University Medical Center, Comprehensive Cancer Center, Columbus, OH, USA.
authors.forename: Leigha
authors.initials: L
authors.lastname: Senter
authors.affiliation: Division of Gynecologic Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.|Department of Molecular Genetics, University of Toronto, Toronto, Canada.
authors.forename: Rochelle
authors.initials: R
authors.lastname: Demsky
authors.affiliation: Program in Cancer Genetics, Department of Oncology and Human Genetics, McGill University, Montréal, QC, Canada.
authors.forename: William D
authors.initials: WD
authors.lastname: Foulkes
authors.affiliation: Genomic Medicine Institute and Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Charis
authors.initials: C
authors.lastname: Eng
authors.affiliation: Gynecology Oncology, Cedars Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Karlan
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Nadine
authors.initials: N
authors.lastname: Tung
authors.affiliation: Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Singer
authors.affiliation: Women's College Research Institute, Women's College Hospital, 76 Grenville Street, 6th Floor, Toronto, ON, M5S 1B2, Canada.
authors.forename: Ping
authors.initials: P
authors.lastname: Sun
authors.affiliation: Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Lubinski
authors.affiliation: Women's College Research Institute, Women's College Hospital, 76 Grenville Street, 6th Floor, Toronto, ON, M5S 1B2, Canada. steven.narod@wchospital.ca.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Narod
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019313:BRCA1 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D016022:Case-Control Studies; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D008593:Menopause / Q000187:drug effects* / Q000235:genetics*; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000235:genetics; D012307:Risk Factors
chemical_list: D019313:BRCA1 Protein
keywords: BRCA1; Breast cancer; Hormone replacement therapy