Sie sind bereits registriert?
Loggen Sie sich mit Ihrem Universimed-Benutzerkonto ein:
Sie sind noch nicht registriert?
Registrieren Sie sich jetzt kostenlos auf universimed.com und erhalten Sie Zugang zu allen Artikeln, bewerten Sie Inhalte und speichern Sie interessante Beiträge in Ihrem persönlichen Bereich zum späteren Lesen. Ihre Registrierung ist für alle Unversimed-Portale gültig. (inkl. allgemeineplus.at & med-Diplom.at)
Gynecologic Surgery and Breast Cancer Risk
Women with a first-degree relative with breast cancer have twice the risk of developing breast cancer, on average, compared with other women. To assess the impact of gynecologic surgery on breast cancer risk in such women, researchers analyzed data from the Sister Study, a nationwide, prospective cohort of roughly 50,000 women aged 35 to 74 years with a biological sister with breast cancer and no breast cancer themselves at enrollment. Participants were enrolled from 2003 to 2009; more than 90% were active through 2019.
At baseline, participants reported history of gynecologic surgery (none; hysterectomy only; bilateral oophorectomy, with or without hysterectomy) as well as age and reason for procedure. Subsequent questionnaires every 2 to 3 years captured interim gynecologic surgeries. Use of hormone replacement therapy was also captured. The primary outcome was self-reported noninvasive or invasive breast cancer, which was confirmed by examination of medical records.
At baseline, 13.8% of participants reported hysterectomy only and 18.1% reported bilateral oophorectomy, with or without hysterectomy. During a median follow-up of 11.4 years, 3948 cases of breast cancer were diagnosed. Compared with no surgery, bilateral oophorectomy was inversely associated with breast cancer (hazard ratio, 0.91) whereas hysterectomy alone was positively associated (HR, 1.12). Compared with no surgery and no hormone therapy, bilateral oophorectomy combined with estrogen-only therapy was inversely associated with breast cancer (HR, 0.83) whereas hysterectomy combined with estrogen plus progestin therapy was positively associated (HR, 1.25).
Gynecologic surgery has been thought to decrease the risk for breast cancer, but some studies provide conflicting results. This well-done study shows that the type of surgery performed as well as the composition of hormone replacement therapy, if given, can influence the subsequent risk of breast cancer. As many prior observational studies have suggested, bilateral oophorectomy significantly reduces estrogen levels and, by extension, breast cancer risk, regardless of estrogen supplementation. Patients undergoing hysterectomy alone with combined estrogen/progestin replacement have an elevated risk for breast cancer.
Lovett SM et al.
Title: Hysterectomy, bilateral oophorectomy, and breast cancer risk in a racially diverse prospective cohort study.
Source: J Natl Cancer Inst 2023 Feb 20; [e-pub]. (Abstract/FREE Full Text)