Breast Cancer Research and Treatment

, Volume 145, Issue 2, pp 439–447 | Cite as

Fatal breast cancer risk in relation to use of unopposed estrogen and combined hormone therapy

  • Gaia Pocobelli
  • Polly A. Newcomb
  • Christopher I. Li
  • Linda S. Cook
  • William E. Barlow
  • Noel S. Weiss


Use of combined hormone therapy (CHT) is associated with increased breast cancer incidence, but it is unclear whether this translates into increased breast cancer mortality. To address this question, we conducted a population-based nested case–control study in Saskatchewan, Canada, where a population-based prescription drug database has existed since 1975. We evaluated fatal breast cancer risk in relation to recency and duration of use of CHT and unopposed estrogen hormone therapy (EHT). A total of 1,288 cases and 12,535 controls were included in the analyses. Exclusive use of EHT was not associated with fatal breast cancer risk, either overall or within categories of recency or duration [odds ratio (OR) for current vs. never use = 1.1; 95 % confidence interval (CI) 0.8–1.3]. Use of CHT (includes women who had also used EHT) was also not associated with fatal breast cancer risk (OR for current vs. never use = 0.9; 95 % CI 0.7–1.3), except for a suggestion of an increased risk with current long-term use. Consistent with prior studies, we observed no increased risk of fatal breast cancer associated with use of EHT. To date only a few studies have evaluated fatal breast cancer risk in relation to use of CHT, and collectively the results are inconsistent.


Breast cancer Estrogen Progestin Mortality Menopause 



We thank Dr. MaryRose Stang of the Saskatchewan Ministry of Health for assistance with data acquisition, and Barb Byrne Simon and Matthew Anderson of the University of Washington for administrative support. This Study is based in part on de-identified data provided by the Saskatchewan Ministry of Health. The interpretation and conclusions contained herein do not necessarily represent those of the Government of Saskatchewan or the Saskatchewan Ministry of Health.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10549_2014_2911_MOESM1_ESM.doc (90 kb)
Supplementary material 1 (DOC 89 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Gaia Pocobelli
    • 1
    • 6
  • Polly A. Newcomb
    • 1
    • 2
  • Christopher I. Li
    • 1
    • 2
  • Linda S. Cook
    • 3
  • William E. Barlow
    • 4
    • 5
    • 6
  • Noel S. Weiss
    • 1
    • 2
  1. 1.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  2. 2.Public Health Sciences DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Division of Epidemiology and Biostatistics, Department of Internal MedicineUniversity of New MexicoAlbuquerqueUSA
  4. 4.Department of BiostatisticsUniversity of WashingtonSeattleUSA
  5. 5.Cancer Research and BiostatisticsSeattleUSA
  6. 6.Group Health Research InstituteSeattleUSA

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