Table 3. (a–c) The risk of invasive ductal carcinoma, with different prognostic characteristics following the use of HRT.
|
(a) | ||||||||
|---|---|---|---|---|---|---|---|---|
| No of cases | Receptor status positive | No of cases | Receptor status negative | No of cases | Low malignancy grade (grade 1) | No. of cases | High malignancy grade (grade 2+3) | |
| HRT use | N=126/10 874 | RR (95% CI)a | N=32/10 874 | RR (95% CI)b | N=60/10 874 | RR (95% CI)c | N=101/10 874 | RR (95% CI)c |
| Never/past | 63 | 1.00 | 25 | 1.00 | 26 | 1.00 | 63 | 1.00 |
| Current | 63 | 3.29 (2.27–4.77) | 7 | 0.99 (0.42–2.36) | 34 | 4.13 (2.43–7.01) | 38 | 2.17 (1.42–3.30) |
| Current users pos vs neg receptor.status: P=0.013 | Current users low vs high malignancy grade: P=0.063 | |||||||
| Never | 54 | 1.00 | 19 | 1.00 | 22 | 1.00 | 52 | 1.00 |
| Past | 9 | 0.65 (0.32–1.31) | 6 | 1.30 (0.48–3.55) | 4 | 0.70 (0.24–2.03) | 11 | 0.82 (0.43–1.58) |
| Current oestrogen | 11 | 2.52 (1.31–4.84) | 1 | 0.70 (0.09–5.22) | 2 | 1.07 (0.25–4.56) | 10 | 2.49 (1.26–4.91) |
| E+ prog-P Cyclical | 15 | 4.78 (2.60–8.79) | 0 | na | 10 | 7.62 (3.50–16.57) | 4 | 1.50 (0.53–4.22) |
| E+ test-P Cyclical | 19 | 2.63 (1.52–4.55) | 4 | 1.62 (0.53–4.95) | 9 | 2.85 (1.28–6.35) | 15 | 2.27 (1.25–4.13) |
| E+ test-P Continuous | 12 | 4.28 (2.22–8.24) | 2 | 2.27 (0.52–9.90) | 9 | 7.87 (3.59–17.28) | 6 | 2.51 (1.07–5.87) |
| Current Tibolone | 2 | 3.22 (0.78–13.25) | 0 | na | 1 | 3.78 (0.51–28.10) | 2 | 3.45 (0.84–14.21) |
| Current other HRT | 4 | 1.86 (0.67–5.15) | 0 | na | 3 | 3.34 (0.99–11.23) | 1 | 0.51 (0.07–3.67) |
|
(b) | ||||||||
| No. of cases | Lymph node status negative | No. of cases | Lymph node status positive | No. of cases | Small tumour size (<2 cm) | No. of cases | Large tumour size (>2 cm) | |
| HRT use | N=93/10 874 | RR (95% CI)d | N=72/10 874 | RR (95% CI)e | N=97/10 874 | RR (95% CI)b | N=70/10 874 | RR (95% CI)c |
| Never/past | 48 | 1.00 | 41 | 1.00 | 52 | 1.00 | 40 | 1.00 |
| Current | 45 | 2.58 (1.67–4.00) | 31 | 2.52 (1.32–4.83) | 45 | 2.57 (1.67–3.97) | 30 | 2.74 (1.67–4.50) |
| Current users neg vs pos lymph node status: P=0.95 | Current users small vs large tumour size: P=0.86 | |||||||
| Never | 37 | 1.00 | 37 | 1.00 | 44 | 1.00 | 32 | 1.00 |
| Past | 11 | 1.11 (0.54–2.22) | 4 | 0.26 (0.04–1.99) | 8 | 0.83 (0.39–1.77) | 8 | 0.95 (0.44–2.06) |
| Current oestrogen | 6 | 1.86 (0.78–4.42) | 5 | 1.89 (0.55–6.47) | 5 | 1.47 (0.58–3.74) | 6 | 2.41 (1.00–5.78) |
| E+ prog-P cyclical | 8 | 3.03 (1.33–6.92) | 7 | 3.11 (1.13–8.55) | 8 | 2.77 (1.22–6.27) | 7 | 4.40 (1.88–10.29) |
| E+ test-P cyclical | 16 | 2.48 (1.31–4.68) | 9 | 1.54 (0.60–3.98) | 17 | 2.32 (1.23–4.36) | 8 | 2.02 (0.90–4.51) |
| E+ test-P continuous | 9 | 4.02 (1.86–8.70) | 8 | 3.69 (1.24–10.98) | 7 | 3.42 (1.53–7.68) | 9 | 6.24 (2.94–13.22) |
| Current Tibolone | 3 | 6.50 (1.99–21.18) | 1 | 4.13 (0.55–31.17) | 4 | 8.50 (3.03–23.82) | 0 | Na |
| Current other HRT | 3 | 1.31 (0.31–5.45) | 1 | 1.26 (0.17–9.52) | 4 | 1.91 (0.59–6.21) | 0 | Na |
|
(c) | ||||||||
| No. of cases | Low stage (stage 1) | No. of cases | High stage (stage 2–4) | No. of cases | NPI good prognosis | No. of cases | NPI moderate/poor prognosis | |
| HRT use | N=65/10 874 | RR (95% CI)d | N=97/10 874 | RR (95% CI)c | N=60/10 874 | RR (95% CI)b | N=92/10 874 | RR (95% CI)c |
| Never/Past | 33 | 1.00 | 55 | 1.00 | 30 | 1.00 | 54 | 1.00 |
| Current | 32 | 2.49 (1.49–4.18) | 42 | 2.71 (1.77–4.13) | 30 | 2.61 (1.52–4.47) | 38 | 2.48 (1.60–3.84) |
| Current users low stage vs high stage: P=0.81 | Current users good prognosis vs mod./poor: P=0.89 | |||||||
| Never | 26 | 1.00 | 47 | 1.00 | 24 | 1.00 | 46 | 1.00 |
| Past | 7 | 1.08 (0.47–2.52) | 8 | 0.65 (0.31–1.38) | 6 | 1.11 (0.45–2.74) | 8 | 0.67 (0.31–1.41) |
| Current oestrogen | 3 | 1.27 (0.38–4.22) | 7 | 1.88 (0.85–4.18) | 1 | 0.50 (0.07–3.70) | 9 | 2.45 (1.20–5.03) |
| E+ prog-P cyclical | 6 | 2.86 (1.077.57) | 9 | 3.68 (1.76–7.71) | 7 | 4.56 (1.93–10.78) | 7 | 2.88 (1.27–6.52) |
| E+ test-P cyclical | 12 | 2.54 (1.23–5.26) | 13 | 2.17 (1.14–4.11) | 12 | 2.47 (1.13–5.41) | 11 | 1.83 (0.92–3.62) |
| E+ test-P continuous | 5 | 3.36 (1.28–8.80) | 11 | 5.11 (2.62–9.94) | 5 | 3.90 (1.48–10.28) | 9 | 4.29 (2.08–8.84) |
| Current Tibolone | 3 | 8.61 (2.59–28.61) | 1 | 1.93 (0.27–14.04) | 2 | 7.03 (1.65–29.85) | 1 | 1.97 (0.27–14.32) |
| Current other HRT | 3 | 1.76 (0.42–7.45) | 1 | 0.56 (0.08–4.10) | 3 | 2.13 (0.50–9.05) | 1 | 0.57 (0.08–4.14) |
E=oestrogen, P=progestin, prog-P= progesterone-like progestin, test-P=testosterone-like progestin. NPI= Nottingham Prognostic Index.
Adjusted for age, benign breast disease (0, yes; 1, no).
Adjusted for age, age at menopause.
Age adjusted.
Adjusted for age, age at menopause (0<55 years; 1, 55+years) and use of oral contraceptives (0, no; 1, yes).
Adjusted for age and night work (0, no; 1, yes).