绝经激素治疗增加乳腺癌患病风险:Lancet最新文献解读

Menopausal Hormone Therapy Increases the Risk of Breast Cancer:Interpretation on an Article Published in the Lancet Sep.2019

绝经激素治疗(menopausal hormone therapy,MHT)是否会增加乳腺癌的发病风险一直存在争议。2019年9月,Lancet发表了一篇荟萃分析,汇集了世界范围内关于MHT与乳腺癌发病风险的证据。此研究结果表明,除阴道应用雌激素外,所有方式应用MHT均增加乳腺癌发病风险,且该风险随MHT应用时间的延长逐渐升高。其中雌激素、孕激素联合治疗风险更高,停药后额外风险可持续10年以上。小剂量应用MHT或选择天然孕激素等并不能回避乳腺癌发病风险的增加。本文对该荟萃分析进行解读,强调应用MHT需考虑乳腺癌风险,全面评估患者风险与获益。

Whether menopausal hormone therapy(MHT)increases the risk of breast cancer has been controversial.In September 2019,the famous medical journal,the Lancet,published a meta-analysis that has gathered the worldwide evidence of MHT and incidence of breast cancer,showing that in addition to vaginal estrogen,all type of MHTs increased the risk of breast cancer,and the risk increased steadily with the duration of MHT use.The risk was greater for oestrogen-progestagen therapy;the excess risk persisted after the drug was stopped for more than 10 years.Low doses of MHT or natural progesterone do not prevent the risk of breast cancer.This article interprets the meta-analysis and emphasizes that MHT should be taken into account of increasing the risk of breast cancer,and the risks and benefits should be fully evaluated.