A study published online by J Natl Cancer Inst on July 6th shows that the effects of progestational drugs on the risk of early-onset breast cancer (age less than 50 years old at diagnosis) Different people.
Dr. Chunyuan Fei and colleagues at the National Institute of Environmental Health Sciences in the United States used data from the "Two Sisters Study." This is a case-control study in which one of the recruited sisters was diagnosed with breast cancer before the age of 50 and the other was not. Of the 1,422 breast cancer patients and their non-breast cancer sisters, 288 reported that they were using clotting drugs clomiphene citrate and (or) follicle stimulating hormone.
The results showed that the risk of breast cancer in those using progestational drugs was lower than in non-users, but the difference was not significant (OR, 0.82; 95% CI, 0.63 to 1.08). However, this risk reduction may only be related to clomiphene, a selective estrogen receptor modulator similar to tamoxifen. Few patients use follicle-stimulating hormone alone.
If pregnancy-promoting drugs are used but ≥10 weeks of pregnancy are not available, the use of these drugs is associated with a reduced risk of early-onset breast cancer, with an odds ratio (OR) of 0.62 [95% confidence interval CI), 0.43 to 0.89]. For women who used an ovulation-promoting pregnancy drug and had a pregnancy of ≥10 weeks, the risk of breast cancer was significantly higher than that of unsuccessful treatment (OR, 1.82; 95% CI, 1.10 to 3.00).
Researchers believe that the risk of breast cancer is significantly higher in pregnant women with ≥ 10 pregnancies obtained through progestational drug therapy. "It may be the result of ovulation induction and estrogen levels that are induced by progestational drugs, because ovulation induction can cause early pregnancy in response to ovarian hormones." Abnormally high exposure, thus affecting subsequent breast remodeling". Dr. Fei said: "Our data suggest that the pregnancy caused by the progestational drug is sufficient to offset the risk reduction effect of breast cancer associated with exposure to ovulation stimulation drugs."
But Louise A of the National Cancer Institute of the United States. Dr. Brinton pointed out in an accompanying editorial that there may be another explanation: Women who are successfully conceived may have previously been exposed to high levels of drugs that increase the risk of early-onset breast cancer. She also stressed that early-onset breast cancer has some unique predictors, including closer links with genetic factors. It is likely that there are other factors involved, "it is impossible to determine whether there is an independent genetic-environment interaction." Case-control studies such as the above-mentioned studies can make assumptions, and the exact impact of progestational drugs on breast cancer risk needs to be confirmed in large-scale cohort studies.
Dr. Brinton said: “It is not easy to interpret the results of this study and previous studies. There are data to support these drugs to reduce risk, increase risk, or not affect risk. It can be considered that the relationship between the two is quite complex, so the interpretation of the results must be More cautious.Pregnant drugs have considerable benefits, they will greatly increase women's chance of conception, thereby significantly reducing the risk of long-term breast cancer.It is well known that the impact of pregnancy on breast cancer risk is bidirectional, that is, the risk increases in the short term, but The rising effect diminishes over time and eventually becomes lower."
The study was conducted by the National Institute of Environmental Research and Susan G. Komen for the Cure funding.
Dr. Chunyuan Fei and colleagues at the National Institute of Environmental Health Sciences in the United States used data from the "Two Sisters Study." This is a case-control study in which one of the recruited sisters was diagnosed with breast cancer before the age of 50 and the other was not. Of the 1,422 breast cancer patients and their non-breast cancer sisters, 288 reported that they were using clotting drugs clomiphene citrate and (or) follicle stimulating hormone.
The results showed that the risk of breast cancer in those using progestational drugs was lower than in non-users, but the difference was not significant (OR, 0.82; 95% CI, 0.63 to 1.08). However, this risk reduction may only be related to clomiphene, a selective estrogen receptor modulator similar to tamoxifen. Few patients use follicle-stimulating hormone alone.
If pregnancy-promoting drugs are used but ≥10 weeks of pregnancy are not available, the use of these drugs is associated with a reduced risk of early-onset breast cancer, with an odds ratio (OR) of 0.62 [95% confidence interval CI), 0.43 to 0.89]. For women who used an ovulation-promoting pregnancy drug and had a pregnancy of ≥10 weeks, the risk of breast cancer was significantly higher than that of unsuccessful treatment (OR, 1.82; 95% CI, 1.10 to 3.00).
Researchers believe that the risk of breast cancer is significantly higher in pregnant women with ≥ 10 pregnancies obtained through progestational drug therapy. "It may be the result of ovulation induction and estrogen levels that are induced by progestational drugs, because ovulation induction can cause early pregnancy in response to ovarian hormones." Abnormally high exposure, thus affecting subsequent breast remodeling". Dr. Fei said: "Our data suggest that the pregnancy caused by the progestational drug is sufficient to offset the risk reduction effect of breast cancer associated with exposure to ovulation stimulation drugs."
But Louise A of the National Cancer Institute of the United States. Dr. Brinton pointed out in an accompanying editorial that there may be another explanation: Women who are successfully conceived may have previously been exposed to high levels of drugs that increase the risk of early-onset breast cancer. She also stressed that early-onset breast cancer has some unique predictors, including closer links with genetic factors. It is likely that there are other factors involved, "it is impossible to determine whether there is an independent genetic-environment interaction." Case-control studies such as the above-mentioned studies can make assumptions, and the exact impact of progestational drugs on breast cancer risk needs to be confirmed in large-scale cohort studies.
Dr. Brinton said: “It is not easy to interpret the results of this study and previous studies. There are data to support these drugs to reduce risk, increase risk, or not affect risk. It can be considered that the relationship between the two is quite complex, so the interpretation of the results must be More cautious.Pregnant drugs have considerable benefits, they will greatly increase women's chance of conception, thereby significantly reducing the risk of long-term breast cancer.It is well known that the impact of pregnancy on breast cancer risk is bidirectional, that is, the risk increases in the short term, but The rising effect diminishes over time and eventually becomes lower."
The study was conducted by the National Institute of Environmental Research and Susan G. Komen for the Cure funding.
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