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+ Author Affiliations
- Correspondence to: Catherine Schairer, PhD, National Cancer Institute, 6210 Executive Blvd, Room 8026, Rockville, MD 20852 (e-mail: schairec@exchange.nih.gov).
The article by Chlebowski et al. in this issue of the Journal (1) follows upon eight articles that have described the relationship between estrogen/progestin therapy and invasive breast
cancer risk/mortality in studies from the Women’s Health Initiative (WHI) (2–9). Although a previous analysis addressed relationships between estrogen plus progestin use and breast cancer incidence among
participants in the WHI Observational Study (WHIOS) (5),
a cohort noted to have characteristics similar to participants in the
WHI Randomized Trial (WHIRT), this is the first presentation
of data from the WHIOS related to mortality
outcomes. A major goal of the Chlebowski et al. study was to explore
discrepancies
between the randomized trial, which noted increased
breast cancer mortality and adverse tumor characteristics associated
with
estrogen plus progestin therapy, and previous
observational studies, which have mainly found usage to be associated
with favorable
prognosis breast cancers.
Findings about increased breast cancer incidence associated with estrogen plus progestin therapy from the WHIRT were first
published in 2002 after a mean follow-up of 5.2 years (2). Tumor characteristics were reported after a mean follow-up of 5.6 years; with 199 observed breast cancers in the estrogen
plus progestin group (3), the invasive breast cancers were larger, more likely …
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