The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

The Role of Hormone Replacement Therapy in the Risk for Breast Cancer and Total Mortality in Women with a Family History of Breast Cancer

Thomas A. Sellers, PhD; Pamela J. Mink, MS; James R. Cerhan, MD, PhD; Wei Zheng, MD, PhD; Kristin E. Anderson, PhD; Lawrence H. Kushi, ScD; and Aaron R. Folsom, MD
[+] Article, Author, and Disclosure Information

From the University of Minnesota, Minneapolis, Minnesota; and the University of Iowa, Iowa City, Iowa. Disclaimer: The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute. Grant Support: By grant R01 CA39742 from the U.S. National Cancer Institute. Ms. Mink was supported by a training grant (T32CA09607) from the National Cancer Institute to Dr. Les Robison. Requests for Reprints: Thomas A. Sellers, PhD, Division of Epidemiology, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454. Current Author Addresses: Drs. Sellers, Zheng, Anderson, Kushi, and Folsom and Ms. Mink: Division of Epidemiology, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;127(11):973-980. doi:10.7326/0003-4819-127-11-199712010-00004
Text Size: A A A

Background: The risks and benefits of hormone replacement therapy (HRT) are of considerable interest and importance, especially in terms of whether they differ among subsets of women.

Objective: To determine whether HRT is associated with increased risks for breast cancer and total mortality in women with a family history of breast cancer.

Design: Prospective cohort study.

Setting: Population-based sample of midwestern postmenopausal women enrolled in an observational study of risk factors for cancer.

Participants: Random sample of 41 837 female Iowa residents 55 to 69 years of age.

Measurements: Incidence rates of and relative risks for breast cancer (n = 1085) and total mortality (n = 2035) through 8 years of follow-up were calculated by using data from the State Health Registry of Iowa and the National Death Index.

Results: A family history of breast cancer was reported by 12.2% of the cohort at risk. Among women with a family history of breast cancer, those who currently used HRT and had done so for at least 5 years developed breast cancer at an age-adjusted annual rate of 61 cases per 10 000 person-years (95% CI, 28 to 94 cases); this rate was not statistically significantly higher than the rate in women who had never used HRT (46 cases per 10 000 person-years [CI, 36 to 55 cases]). Among women with a family history, those who used HRT had a significantly lower risk for total mortality than did women who had never used HRT (relative risk, 0.67 [CI, 0.51 to 0.89]), including total cancer-related mortality (relative risk, 0.75 [CI, 0.50 to 1.12]). The age-adjusted annual mortality rate for women using HRT for at least 5 years was 46 deaths per 10 000 person-years (CI, 19 to 74 deaths); this is roughly half the rate seen in women who had never used HRT (80 deaths per 10 000 person-years [CI, 69 to 92 deaths]).

Conclusions: These data suggest that HRT use in women with a family history of breast cancer is not associated with a significantly increased incidence of breast cancer but is associated with a significantly reduced total mortality rate.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.