Whenever MHT began to be used, extremely plans consisted of estrogen by yourself. On the seventies, it had been revealed that the the means to access estrogen-by yourself cures are with the risk of endometrial cancer [step 1,2]. Progestagens was basically then placed into new arrangements so you can contradict the results from estrogens and give a wide berth to endometrial cancers [step 3,4]. Inside 2002, new Ladies Wellness Effort (WHI), a randomized clinical test, reported that using combined the hormone estrogen-progestagen cures try in the a greater incidence out of cancer of the breast . That it book contributed to a remarkable decrease of EP procedures sales [6-9].

Discover a huge brand of MHTs offered globally, that have country-specific brand of molecules and you may regimens (carried on source of progestagen or sequential). It’s been found that profiles regarding mutual estrogen-progestin MHT provides a high danger of breast cancer than simply the hormone estrogen-just profiles, that chance is specially raised when you look at the most recent profiles hence it does increase which have lifetime of use [11,12]. Fixed combinations that have a continuing supply of progestagen was in fact in the a greater chance of breast cancer than sequential combinations . Because more progestagens operate differently to the hormones receptors while having varied biological outcomes , the question comes up toward whether or not more progestagens is actually with the risk distinctions Blijf dit lezen. It has additionally come stated that a short while interval anywhere between start of menopause and commence from MHT will get influence cancer of the breast risk [15-17]. Since MHT medications try strongly influenced by the specific nation in that they are available, direct extrapolations out-of MHT-relevant exposure anywhere between degree presented in different populations are hard.

Inside joint EP therapies used in France, this new the hormone estrogen part is oftentimes estradiol, but agreements will get include an enormous kind of progestagens [18,19]. When you’re micronized progesterone might have been aren’t given when you look at the France, this has hardly come used in different countries [thirteen,18]. Chemically derived progestagens in the EP treatment are most often progesterone-types , if you are testosterone-derivatives, always recommended within the North Europe such as for instance Denmark, Norway, United kingdom otherwise Germany, has been used a lot more hardly in the France [13,18,20]. On the other hand, tibolone a plastic hormonal subscribed regarding 1990’s, which have estrogenic and you may progestogenic functions, might have been recommended since 2000.

Now, there is significant epidemiologic facts one to menopause exposure to exogenous gender steroid hormonal plays an important role regarding growth of breast cancer tumors in females and you will mutual EP hormonal cures has been classified because the carcinogenic so you’re able to human beings (Classification step one)

Research toward cancer of the breast risk with the MHT use in France is actually dependent mostly on the E3N prospective cohort study of French ladies teachers . It absolutely was advertised within this data that breast cancer chance are increased inside most recent profiles away from EP medication that has artificial progestagens, although not from inside the profiles off EP cures with which has absolute micronized progesterone. That it trying to find cannot end up being duplicated within the separate training. It has additionally already been hypothesized that breast cancer chance may differ of the sorts of artificial progestagen (produced by progesterone or away from testosterone) however, zero obvious difference in testosterone- and you may progesterone-derivatives was basically reported [13,21,22]. For tibolone, it had been has just thought to play a role in breast cancer [13,22,23], but abilities haven’t been consistent all over knowledge [20,twenty four,25].

In the present investigation, i intended for exploring cancer of the breast chance from the sort of MHT utilized in France regarding study off an enormous populace-mainly based instance-handle studies. We had been seeking sort of regarding sort of progestagen, regimen and you can slow down ranging from start of menopause and commence off cures.

Procedures

Stability declaration: The research is authorized by the Principles Panel away from Kremlin-Bicetre, France () and also by the National Analysis Shelter Company (). All the users finalized told agree.