HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE COVER ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a letter to the editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content PubMed PubMed Citation

NEWS & VIEWS

INVASIVE LOBULAR CARCINOMA INCIDENCE INCREASING

Incidence rate for invasive lobular carci-noma is rising.

Several recent studies have found that combined estrogen plus progestin hormone replacement therapy (CHRT) increases breast cancer risk. Some of the studies reported an overall increase in all types of invasive breast cancer combined, but others noted a more specific association with lobular but not ductal cancers.

Christopher I. Li, MD, PhD, and colleagues from the Fred Hutchinson Cancer Center and the University of Washington School of Medicine in Seattle, report in the March 19 issue of JAMA (2003;289:1421–1424)[Abstract/Free Full Text] that the proportion of breast cancers with a lobular component increased from 9.5 percent in 1987 to 15.6 percent in 1999. Cancers with a lobular component include those with pure lobular histology as well as those with both lobular and ductal features.

Trends in this proportion are similar to trends in incidence rates, which provide a clearer view of cancer frequency. During this time period, the incidence rate for invasive lobular breast cancer increased from 12.9 to 19.1 cases per 100,000 women per year, and the rate for mixed lobular/ductal cancer increased from 6.9 to 14.3. In contrast, the incidence rates for invasive ductal carcinoma were not significantly different at 153.8 in 1987 and 155.3 in 1999.

The study was based on an analysis of the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program, which collects data from nine population-based US cancer registries.

The authors note that although this study "could not directly address CHRT use in this national registry database, CHRT use has risen over the past several decades, and our data are consistent with the hypothesis that CHRT use is associated with an increased risk of ILC [invasive lobular carcinoma]."

But, according to Jeanne Calle, PhD, ACS director of analytic epidemiology, "CHRT may not entirely explain the increased risk of ILC, since an increased incidence of ILC was seen among women younger than 50 years as well as among older women. The association between CHRT and ILC deserves future study, especially in prospective cohort studies. We are currently reviewing this association in the American Cancer Society’s Cancer Prevention Study cohort."

"Recently published reports of the association between CHRT and increased risk of cardiovascular disease are likely to diminish use of long-term CHRT. If CHRT is indeed the main factor responsible for the increase in ILC reported in this study and if women stopped using CHRT, one would expect this trend of increasing ILC to cease over then next five to ten years."

This Article Full Text (PDF) Submit a letter to the editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content PubMed PubMed Citation