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From The Comprehensive Breast Care Institute (IP, TK, AH), the Division of Surgery (IP, IM, TK, IW, AH), and the Institutes of Oncology (NS-D), Radiology (VS-K), and Pathology (JS), Assaf Harofeh Medical Center, Zerifin (affiliated with the Sackler Faculty of Medicine, University of Tel Aviv), Israel.
Correspondence: Address correspondence and reprint requests to: Itzhak Pappo, MD, The Comprehensive Breast Care Institute, Assaf Harofeh Medical Center, Zerifin 70300, Israel; Fax: 972-8-977-8192; E-mail: pappo{at}zahav.net.il
Background: The purpose of this study was to investigate the characteristics of breast cancer in hormone replacement therapy (HRT) users vs. nonusers.
Methods: We investigated the characteristics of all patients between the ages of 50 and 75 years with breast tumors. Then, an age-adjusted group of 55 nonusers was chosen to match and compare with HRT users.
Results: Of the 243 patients available for evaluation, 55 (22.6%) used HRT. Disease stages in HRT users vs. nonusers were as follows: ductal carcinoma in situ (DCIS), 20% and 17.1%; stage I, 45.5% and 41.7%; stage II, 30.9% and 26.2%; stage III, 3.6% and 13.4%; and stage IV, 0% and 1.6% (P = .27). In the age-adjusted cohort, stages in nonusers were as follows: DCIS, 7.3%; stage I, 47.3%; stage II, 25.5%; stage III, 20%; and stage IV, 0% (P = .03). Tumor grades in HRT users vs. nonusers were as follows: grade I, 30.4% and 15.7%; grade II, 52.2% and 52.2%; and grade III, 17.4% and 32.1% (P = .035). Grades in cohort nonusers were as follows: I, 13.2%; II, 52.8%; and III, 34% (P = .05). In the invasive tumors, the positive estrogen receptor (ER) rates were 81.6% and 85.7% (P = .89); positive progesterone receptor (PR) rates were 53.1% and 54% (P = .95); and Her 2-neu positive rates were 18.4% and 17.6% (P = .95), respectively. No significant difference was found in intratumor DCIS, vascular invasion, and Ki-67 (P = .14, .9, and .79, respectively). The rate of lobular and favorable histological types was higher in the HRT user group: 26.6% vs. 15%.
Conclusions: Breast tumors in HRT users vs. nonusers were of a significantly lower stage and grade and accounted for a higher number of favorable histological types, but all other parameters were similar in the two groups.
Key Words: Breast cancer • Hormone replacement therapy • HRT • Tumor characteristics
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