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Neueste Erkenntnisse (2008) betreffend Hormonersatztherapie und Brustkrebs: Patientinnen, die vor der Diagnose Brustkrebs Hormonersatzpräparate (Kombination von Östrogen und Progesteron) eingenommen haben, haben statistisch signifikant bessere Überlebenschancen und auch ein geringeres Risiko am Krebs zu versterben gegenüber jenen Frauen, die keine Hormone genommen haben. Lesen Sie bitte dazu die folgende Originalarbeit:

 

Pre-Breast Cancer Use of Oestrogen-Progestin Hormone Replacement Therapy Appears to Lower Mortality Risk
By Bruce Sylvester
 

SAN ANTONIO, Tex -- December 14, 2008 -- Women who use combination oestrogen-progestin hormone-replacement therapy (HT) prior to a breast-cancer diagnosis are less likely to die from the cancer, researchers reported at the 31st Annual San Antonio Breast Cancer Symposium (SABCS).

“The combination hormone therapy taken before diagnosis improved survival, and it was a statistically significant finding,” said lead investigator Sarah Marshall, MA, University of California at Irvine, Irvine, California, speaking here on December 13.

Ms. Marshall and colleagues noted that breast-cancer survival appears to be improved with prediagnostic use of HT, but it has not been clear whether this is due to a direct effect of HT or because HT leads to the development of tumour types with a better prognosis. “It is therefore important to examine whether the association between HT use and survival still remains after adequate adjustment for tumour characteristics,” they said.

The investigators extracted data from the ongoing California Teachers Study, including data on 133,479 women. The data set included 2,783 postmenopausal women whose HT use was documented and who were also diagnosed with an incident primary invasive breast cancer after joining the cohort in 1995-1996. These women were followed until death or the end of 2005.

The investigators identified incident cancers and tumour characteristics through annual linkage with the statewide California Cancer Registry. HT and other covariates were self-reported on a baseline questionnaire. The researchers estimated the relative risk (RR) of breast-cancer death by stratifying according to age in years, and using age in days from breast-cancer diagnosis as the time scale.

They reported that during the follow-up period, 159 (5.7%) women died of breast cancer.

They also reported that among the women who used prediagnosis oestrogen- progestin, the risk of dying from their breast cancer was reduced by 63% compared with women who did not use hormones (RR = 0.37; 0.24-0.57, P < .0001); there was a 36% reduction for those who used oestrogen only (RR = 0.64; 0.43-0.95).

Adjusting for the fact that women who use hormones tend to be leaner, exercise more, and smoke less, as well as adjusting for tumour characteristics and treatment received, the investigators still found a 47% reduced risk of breast-cancer death among the women who used oestrogen-progestin (RR = 0.53; 0.33-0.84) and an 18% among [oestrogen-only] subjects (RR = 0.82; 0.53-1.27).

The researchers concluded that the “use of oestrogen-progestin before diagnosis was associated with a reduced risk of death due to breast cancer. Use of oestrogen was also associated with reduced breast-cancer mortality, although the association was not statistically significant after adjustment for indicators of general health, characteristics of tumour, and treatment.”

[Presentation title: Hormone Therapy Use Before Diagnosis and Breast Cancer Survival in the California Teachers Study. Abstract 65]