Correspondence

Estrogens and Breast Cancer

N Engl J Med 2006; 354:1647-1648April 13, 2006

Article

To the Editor:

Yager and Davidson (Jan. 19 issue)1 state unequivocally that the use of oral contraceptives is associated with an increased risk of breast cancer. This view is not supported by an article that appeared in the Journal in 20022 and in the accompanying editorial.3 In light of this recent information, I hope that the authors will modify their conclusions.

Charles L. Blander, M.D.
North Shore Medical Center, Salem, MA 01970
cblander@blandermd.com

3 References

1. 1

   Yager JD, Davidson NE. Estrogen carcinogenesis in breast cancer. N Engl J Med 2006;354:270-282
   Full Text | Web of Science | Medline

2. 2

   Marchbanks PA, McDonald JA, Wilson HG, et al. Oral contraceptives and the risk of breast cancer. N Engl J Med 2002;346:2025-2032
   Full Text | Web of Science | Medline

3. 3

   Davidson NE, Helzlsouer KJ. Good news about oral contraceptives. N Engl J Med 2002;346:2078-2079
   Full Text | Web of Science | Medline

Author/Editor Response

Dr. Blander is concerned that recent data do not support our statement that the use of oral contraceptives is associated with a small but significant risk of breast cancer. Our conclusion rests on the 1996 meta-analysis of oral-contraceptive use and breast cancer.1 We agree that results reported by Marchbanks et al., which received a favorable comment from one of us,2 did not support this association. However, the conclusion from the study by Marchbanks et al. must be tempered by the subsequent report by Kumle et al.,3 which described a prospective study of more than 100,000 women between the ages of 30 and 49 years at the time of enrollment. It demonstrated that current or recent use of oral contraceptives is associated with an increased risk of breast cancer. For this reason, we continue to believe that the totality of the evidence suggests a small but real increase in the risk of breast cancer for current users. Of course, this small absolute risk must be considered in the context of the numerous health benefits that oral-contraceptive use affords to so many young women.

James D. Yager, Ph.D.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205
jyager@jhsph.edu

Nancy E. Davidson, M.D.
Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21205

3 References

1. 1

   Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet 1996;347:1713-1727
   CrossRef | Web of Science | Medline

2. 2

   Davidson NE, Helzlsouer KJ. Good news about oral contraceptives. N Engl J Med 2002;346:2078-2079
   Full Text | Web of Science | Medline

3. 3

   Kumle M, Weiderpass E, Braaten T, Persson I, Adami H-O, Lund E. Use of oral contraceptives and breast cancer risk: the Norwegian-Swedish Women's Lifestyle and Health Cohort Study. Cancer Epidemiol Biomarkers Prev 2002;11:1375-1381
   Web of Science | Medline

Citing Articles (1)

Citing Articles

1. 1

   Ying-Wei Li, Guo-Yuan Zhu, Xiao-Ling Shen, Jian-Hong Chu, Zhi-Ling Yu, Wang-Fun Fong. (2011) Furanodienone inhibits cell proliferation and survival by suppressing ERα signaling in human breast cancer MCF-7 cells. Journal of Cellular Biochemistry 112:1, 217-224
   CrossRef