An epidemiologic study of breast cancer and benign breast neoplasias in relation to the oral contraceptive and estrogen use

Ravnihar, B; Seigel, Daniel; Lindtner, Jurij

doi:10.1016/0014-2964(79)90074-4

Cited by 74 publications

(39 citation statements)

References 15 publications

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“…Since the appearance of our last detailed report (Vessey et al, 1979), the results of a considerable number of additional epidemiological studies of the possible association between oral contraceptive use and breast cancer have been published (Paffenbarger et al, 1979;Ravnihar et al, 1979;Jick et al, 1980;Matthews et al, 1981;Pike et al, 1981;Royal College of General Practitioners, 1981;Vessey et al, 1981;Trapido, 1981;Harris et In our last full analysis (Vessey et al, 1979), we noted that a smaller proportion of women with breast cancer than of matched controls reported never having used any method of birth control at all. The addition of data for a further 555 pairs of patients has left this association unchanged.…”

Section: Discussionmentioning

confidence: 99%

Oral contraceptives and breast cancer: Final report of an epidemiological study

Vessey¹,

Baron

Doll³

et al. 1983

Br J Cancer

160

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Summary During [1968][1969][1970][1971][1972][1973][1974][1975][1976][1977][1978][1979][1980], 1176 women aged 16-50 years with newly diagnosed breast cancer and a like number of matched controls were interviewed at 9 teaching hospitals in London and Oxford and asked about their use of oral contraceptives. The results were reassuring. A few statistically significant differences in oral contraceptive use were found between the breast cancer and control groups, but the data were subdivided in many ways so that some "significant" differences would have been expected through the play of chance alone. Certainly no patterns of risk emerged which would suggest that any of the associations were causal. It must be stressed, however, that the data are still sparse in some importanr subcategories-for example, only small numbers of both cases and controls had prolonged oral contraceptive use before their first term pregnancy. For this reason, it is important that information on the possible relationship between pill use and breast cancer should continue to be collected. Women who had never used oral contraceptives presented with appreciably more advanced tumours than those who had been using oral contraceptives during the year before detection of cancer, while past users were in an intermediate position. These differences in staging were reflected in the pattern of survival. Possible explanations for these observations include "surveillance bias" among oral contraceptive users leading to earlier diagnosis and a beneficial biological effect of oral contraceptives on tumour growth and spread. Women with breast cancer reported never having used any method of contraception and heavy cigarette smoking (> 15 per day) significantly less often than controls. We could find no obvious explanation for the former observation, but suspect that the latter reflects the unrepresentative smoking habits of our hospital controls rather than a protective effect of smoking against breast cancer.

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Section: Discussionmentioning

confidence: 99%

Oral contraceptives and breast cancer: Final report of an epidemiological study

Vessey¹,

Baron

Doll³

et al. 1983

Br J Cancer

160

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“…12 Inhibition of fi broadenoma growth using oral contraceptives or hormone replacement therapy is still a controversial topic. While Ravnihar et al 13 demonstrated that hormone therapy is a protection factor, Sitruk-Ware et al 14 did not observe such infl uence. The greatest controversy relating to hormonal oral contraception is its association with the risk of developing breast cancer.…”

Section: Introductionmentioning

confidence: 95%

Efficacy of estriol in inhibiting epithelial proliferation in mammary fibroadenoma: randomized clinical trial

et al. 2007

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CONTEXT AND OBJECTIVE: Mammary fibroadenoma is a disease that affects a large number of women of reproductive age. The aim of this study was to evaluate the proliferative activity of mammary fibroadenoma through expression of Ki-67 and c-myc antigens, following administration of oral contraceptive with or without estriol. DESIGN AND SETTING: Placebo-controlled double-blind randomized clinical trial in the Mastology Sector of the Department of Gynecology, Universidade Federal de São Paulo. METHODS: Thirty-three fibroadenoma patients were studied. Ten women (group 1) took an oral contraceptive constituted by levonorgestrel and ethinyl estradiol together with placebo manufactured in the same capsule for four consecutive cycles with a seven-day interval between them. The other 23 patients (group 2) took the same oral contraceptive together with estriol, which was put into the same capsule and used in the same way as among the group 1 patients. After four cycles, the nodules were surgically removed and sent for immunohistochemical analysis of Ki-67 and c-myc expression. RESULTS: The Ki-67 and c-myc analysis did not reveal any significant differences between the study groups. The values were 9.16 and 10.54 for group 1 and 10.86 and 17.03 for group 2, respectively. There was a tendency towards higher expression of antigens in group 2. CONCLUSION: Our results showed that there was no significant statistical difference in Ki-67 and c-myc expression between our study groups, but only a tendency towards higher expression among users of oral contraceptives containing estriol.

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“…6,7,9,10 Conversely, body mass index and the number of full-term pregnancies were found to have a negative correlation with the risk of fibroadenomas. [5][6][7]9,11 Moreover, consumption of large quantities of vitamin C and cigarette smoking were found to be associated with reduced risk of a fibroadenoma. 7,12,13 No genetics factors are known to alter the risk of fibroadenoma.…”

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confidence: 99%

Management of breast fibroadenomas

1998

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F ibroadenomas are common benign lesions of the breast that usually present as a single breast mass in young women. They are assumed to be aberrations of normal breast development or the product of hyperplastic processes, rather than true neoplasms. The clinician often faces the dilemma whether to remove the mass or to monitor it by means of periodic follow-up examinations. Although removal of these lesions is a definitive solution, surgery may involve unnecessary excisions of benign lesions and unbecoming cosmesis. Moreover, a policy of conducting surgery on all patients with fibroadenomas would place an enormous burden on health care systems. A balanced and rational approach to the management of a fibroadenoma of the breast needs to address the crucial questions about its association with breast cancer, especially whether or not it is a marker of increased risk of breast malignancy. Another consideration to be weighed is that a substantial percentage of these lesions undergo spontaneous regression. Herein, based on our review of the current data on fibroadenomas of the breast and our experience, we propose practical algorithms for their management. INCIDENCE AND RISK FACTORSThere are no clear-cut data on the incidence of fibroadenomas in the general population. In one study, the rate of occurrence of fibroadenomas in women who were examined in breast clinics was 7% to 13%, 1 while it was 9% in another study of autopsies. 2 Fibroadenomas comprise about 50% of all breast biopsies, and this rate rises to 75% for biopsies in women under the age of 20 years. 3,4 Fibroadenomas are more frequent among women in higher socioeconomic classes 5-7 and in dark-skinned populations. 8 The age of menarche, the age of menopause, and hormonal therapy, including oral contraceptives, were shown not to alter the risk of these lesions. 6,7,9,10 Conversely, body mass index and the number of full-term pregnancies were found to have a negative correlation with the risk of fibroadenomas. [5][6][7]9,11 Moreover, consumption of large quantities of vitamin C and cigarette smoking were found to be associated with reduced risk of a fibroadenoma. 7,12,13 No genetics factors are known to alter the risk of fibroadenoma. However, a family history of breast cancer in firstdegree relatives was reported by some investigators to be related with increased risk of developing these tumors. 14,15 PATHOLOGYFibroadenomas usually form during menarche (15-25 years of age), a time at which lobular structures are added to the ductal system of the breast (Fig. 1). Hyperplastic lobules are common at that time, and may be regarded as a normal phase of breast development. 16 Hyperplastic lobules were shown to be histologically identical with fibroadenomas. 10,17 Analyses of the cellular components of fibroadenomas by means of polymerase chain reaction demonstrated that both the stromal and the epithelial cells are polyclonal, 18 supporting the theory that fibroadenomas are hyperplastic lesions associated with aberration of the normal maturation of the breast, ra...

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An epidemiologic study of breast cancer and benign breast neoplasias in relation to the oral contraceptive and estrogen use

Cited by 74 publications

References 15 publications

Oral contraceptives and breast cancer: Final report of an epidemiological study

Oral contraceptives and breast cancer: Final report of an epidemiological study

Efficacy of estriol in inhibiting epithelial proliferation in mammary fibroadenoma: randomized clinical trial

Management of breast fibroadenomas

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