Combined HRT increases risk of lobular breast cancer fourfold after just 3 ye...( SEATTLE Postmenopausal women who ta...),Health

SEATTLE Postmenopausal women who take combined estrogen/progestin hormone-replacement therapy for three years or more face a fourfold increased risk of developing various forms of lobular breast cancer, according to new findings by researchers at Fred Hutchinson Cancer Research Center.

Previous research indicated that five or more years of combined hormone-therapy use was necessary to increase overall breast-cancer risk, said Christopher I. Li, M.D., Ph.D., the lead author of the report, published in the January issue of Cancer Epidemiology, Biomarkers and Prevention. Our study, the first specifically designed to evaluate the relationship between combined HRT and lobular breast cancers, suggests that a significantly shorter length of exposure to such hormones may confer an increased risk.

The study, which confirms previous reports of the association between combined hormone-therapy use and increased risk of lobular breast cancers, is the largest study of combined HRT and lobular cancer risk in the United States. It is also the first such study to take into account the recency and duration of hormone use and the first to include a centralized pathological review of tumor specimens to confirm their histological type: ductal, lobular or mixed ductal-lobular.

Lobular cancer involves the lobules, or chambers, in the breast that contain milk-producing glands. While lobular carcinoma accounts for only about 15 percent of all invasive breast cancers, it is hormonally sensitive and therefore more treatable than the more common ductal variety, which arises in the ducts that carry milk from the lobules to the nipple. However, lobular breast tumors also present a clinical challenge because they are more difficult to detect both by clinical examination and by mammography than ductal cancers, which account for about 70 percent of invasive breast cancers in the United States.

The study assessed hormone-replacement status in more than 1,500 postmenopausal wome
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