DESCRIPTION (Adapted from the Applicant's Abstract): Incidence rates of
invasive lobular breast carcinomas (ILBC) have increased steadily in the United
States since 1977, whereas the trend of increasing incidence of ductal breast
cancer has plateaued since 1987. This rise in lobular tumors has occurred
specifically among women over age 50. The use of combined estrogen-progestin
hormone replacement therapy (CHRT) has also risen steadily over this time
period, and recent analyses from two case-control investigations suggest that
postmenopausal women who use CHRT may have an increased risk of ILBC, whereas
there is no relationship of CHRT to ductal cancer. Few epidemiologic studies
have assessed how known or suspected risk factors for breast cancer differ
across different histologic types, but such investigations are important
because there are likely to be multiple pathways leading to the development and
progression of breast cancer of different histologic types.
The primary objectives of this proposed study are to confirm recent preliminary
findings that CHRT is associated with lobular breast cancer in a large
population-based study, to assess this relationship in greater detail, and to
explore mechanisms for this association.
We propose to conduct a case-control study of 900 women aged 55-79 who have
been diagnosed with breast cancer (450 lobular, 450 ductal) and 450
population-based controls who reside in the three county Seattle-Puget Sound
metropolitan area of western Washington. The specific questions to be addressed
are: (1) Is the use of CHRT associated with an increase in the incidence of
invasive lobular breast cancer in women aged 55-79. (2) Is the use of CHRT
associated with an increase in the incidence of invasive ductal breast cancer
in women aged 55-79? (3) Do the duration, patterns and/or recency of CHRT use
influence he size of the association? (4) Is the use of CHRT associated with
alteration in the histologic characteristics, tumor cell proliferation, or
expression of steroid hormone receptors, oncogenes, and cell cycle and cell
death regulator proteins of lobular and ductal breast cancers?
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