Influence of the dramatic fall of HRT prescription on postmenopausal breast cancer incidence: The Austrian Data

1529 Background: The Women's Health Initiative trial showed a significant increase in breast cancer risk among women using HRT. This publication led to a dramatic fall in HRT prescription worldwide. Several studies argued that the ensuing decline in breast cancer incidence among postmenopausal women was due to the reduced HRT prescriptions. We have investigated whether the strong decline in HRT prescription in Austrian women from 2002 onward was associated with a decrease in postmenopausal breast cancer incidence in Austria. Methods: Breast cancer incidence data were obtained from the National Austrian Cancer Registry. HRT prescription data were calculated using Pharmaceutical Benefits Scheme data. Hormone receptor expression data were taken from the pathology report of all patients with breast cancer, who were operated on at the Division of Special Gynecology, as well as the Department of Surgery, Medical University of Vienna (MUW), from 1998 to 2000, and 2005 to 2007, respectively. Chi-Square test was used to identify significant differences. Results: HRT prescription slightly increased from 1998 to 2000, but dramatically decreased by 70% after 2003, reaching a significantly lower level. When comparing breast cancer incidence data from 1999 and 2004, a nonsignificant trend toward a decreased incidence in 50- to 54-year-old women could be observed. Comparing predicted breast cancer incidence for 2004 with the actual incidence for 2004 in this group, a significant decrease could be demonstrated. Ten percent to 12% of all new breast cancers in Austria are treated at the MUW every year. Regarding histopathologic breast cancer parameters of patients treated at the MUW from 1998 to 2000 and 2005 to 2007, respectively, a nonsignificant decline of hormone receptor positive tumors in 50- to 54-year-old patients with breast cancer could be observed. Conclusions: The decline of HRT use in Austria is associated with a reduction in breast cancer incidence in postmenopausal women. Our data underline the association between HRT and breast cancer. No significant financial relationships to disclose.

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Dietary Energy Density and Postmenopausal Breast Cancer Incidence in the Cancer Prevention Study II Nutrition Cohort

Journal of Nutrition ◽

10.3945/jn.116.234344 ◽

2016 ◽

Vol 146 (10) ◽

pp. 2045-2050 ◽

Cited By ~ 6

Author(s):

Terryl J Hartman ◽

Susan M Gapstur ◽

Mia M Gaudet ◽

Roma Shah ◽

W Dana Flanders ◽

...

Keyword(s):

Breast Cancer ◽

Energy Density ◽

Cancer Prevention ◽

Cancer Incidence ◽

Breast Cancer Incidence ◽

Postmenopausal Breast Cancer ◽

Dietary Energy ◽

Prevention Study ◽

Dietary Energy Density

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Use of Aspirin, Other Nonsteroidal Anti-Inflammatory Drugs, and Acetaminophen and Postmenopausal Breast Cancer Incidence

Journal of Clinical Oncology ◽

10.1200/jco.2012.42.2006 ◽

2012 ◽

Vol 30 (28) ◽

pp. 3468-3477 ◽

Cited By ~ 40

Author(s):

Xuehong Zhang ◽

Stephanie A. Smith-Warner ◽

Laura C. Collins ◽

Bernard Rosner ◽

Walter C. Willett ◽

...

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Cancer Incidence ◽

Molecular Subtype ◽

Breast Cancer Incidence ◽

Postmenopausal Breast Cancer ◽

Luminal A ◽

Inflammatory Drugs ◽

Cox 2 ◽

Anti Inflammatory

Purpose The associations between use of aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen and breast cancer incidence in postmenopausal women are uncertain. We examined these associations with breast cancer, both overall and by molecular subtype. Patients and Methods We observed 84,602 postmenopausal women, free of cancer in 1980, until June 2008 and prospectively collected data on analgesic use, reproductive history, and other lifestyle factors using biennial questionnaires. Proportional hazards models were used to estimate multivariable relative risks (RRs) and 95% CIs. Results We documented 4,734 cases of incident invasive breast cancer. Compared with nonuse of aspirin, multivariable RRs of regular aspirin use (≥ two tablets per week) for more than 20 years were 0.91 for overall breast cancer (95% CI, 0.81 to 1.01; Ptrend = 0.16), 0.90 for estrogen receptor (ER) –positive progesterone receptor (PR) –positive breast cancer (95% CI, 0.77 to 1.06; Ptrend = 0.17), and 0.91 for ER-negative PR-negative breast cancer (95% CI, 0.68 to 1.22; Ptrend = 0.97). Results did not vary appreciably by past or current use, days per week of use, or dosage of use. Use of other NSAIDs and acetaminophen was largely not significantly associated with breast cancer risk. Additionally, use of higher doses of each analgesic (≥ six tablets per week) for more than 10 years was generally not significantly associated with risk of breast cancer, either overall or by subtype. Furthermore, largely no substantial associations were noted for breast cancer molecular subtypes, including luminal A, luminal B, triple negative, basal-like, human epidermal growth factor receptor 2 positive, cyclooxygenase-2 (COX-2) negative, and COX-2 positive. Conclusion Our study suggests that use of aspirin, other NSAIDs, and acetaminophen is not importantly associated with risk of postmenopausal breast cancer, either overall or by specific subtype.

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