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Menopausal Estrogen Replacement Therapy and Breast Cancer

Menopausal Estrogen Replacement Therapy and Breast Cancer Abstract We conducted a meta-analysis of the literature concerning breast cancer and estrogen replacement therapy. The overall relative risk of breast cancer associated with this therapy was 1.07. However, the variation of the estimated risks among the studies was far greater than could plausibly be explained by chance alone. To explain this variation, we looked at the effects of type, duration, and dosage of treatment. Overall, women who took 0.625 mg/d or less of conjugated estrogens had a risk of breast cancer that was 1.08 times that of women who did not receive this therapy (95% confidence interval [CI], 0.96 to 1.2). The relative risks from these individual studies of low-dosage therapy did not differ significantly from each other. Women who took 1.25 mg/d or more of conjugated estrogens had a breast cancer relative risk of 2.0 or less in all studies. However, the variation in observed risks at this higher dosage was significant. This implies that other risk factors varied among these studies, making it difficult to estimate the overall risk associated with this dosage. The relative risk of breast cancer associated with estro gen replacement therapy among women with a history of benign breast disease was 1.16 (95% CI, 0.89 to 1.5). The combined results from multiple studies provide strong evidence that meno pausal therapy consisting of 0.625 mg/d or less of conjugated estrogens does not increase breast cancer risk. (Arch Intern Med. 1991;151:67-72) References 1. References 5,6, 9-26, 28-34, 39, 40,43-45, 51-53. 2. References 4,7, 8,27,35-38,41,42,46-50. 3. References 4-7,10-12,14,17,20-22, 27, 31. 4. Council on Scientific Affairs. Estrogen replacement in the menopause . JAMA. 1983;249:359-361.Crossref 5. Bush TL, Barrett-Connor E. Noncontraceptive estrogen use and cardio vascular disease . Epidemiol Rev. 1985;7:80-104. 6. Kelsey JL, Berkowitz GS. Breast cancer epidemiology . Cancer Res. 1988;48:5615-5623. 7. Mack TM, Henderson BE, Gerkins VR, Arthur M, Baptista J, Pike MC. Reserpine and breast cancer in a retirement community . N Engl J Med. 1975;292:1366-1371.Crossref 8. Hoover R, Gray LA Sr, Cole P, MacMahon B. Menopausal estrogens and breast cancer . N Engl J Med. 1976;295:401-405.Crossref 9. Casagrande J, Gerkins V, Henderson BE, Mack T, Pike MC. Brief communication: exogenous estrogens and breast cancer in women with natural menopause . J Natl Cancer Inst. 1976;56:839-841. 10. Byrd BF Jr, Burch JC, Vaughn WK. The impact of long term estrogen support after hysterectomy . Ann Surg. 1977;185:574-579.Crossref 11. Wynder EL, MacCornack FA, Stellman SD. The epidemiology of breast cancer in 785 United States Caucasian women . Cancer. 1978;41:2341-2354.Crossref 12. Ravnihar B, Seigel DG, Lindtner J. An epidemiologic study of breast cancer and benign breast neoplasias in relation to the oral contraceptive and estrogen use . Eur J Cancer Clin Oncol. 1979;15:395-405. 13. Jick H, Walker AM, Watkins RN, et al. Replacement estrogens and breast cancer . Am J Epidemiol. 1980;112:586-594. 14. Ross RK, Paganini-Hill A, Gerkins VR, et al. A case-control study of menopausal estrogen therapy and breast cancer . JAMA. 1980;243:1635-1639.Crossref 15. Hoover R, Glass A, Finkle WD, Azevedo D, Milne K. Conjugated estrogens and breast cancer risk in women . J Natl Cancer Inst. 1981;67:815-820. 16. Kelsey JL, Fischer DB, Holford TR, et al. Exogenous estrogens and other factors in the epidemiology of breast cancer . J Natl Cancer Inst. 1981;67:327-333. 17. Thomas DB, Persing JP, Hutchinson WB. Exogenous estrogens and other risk factors for breast cancer in women with benign breast disease . J Natl Cancer Inst. 1982;69:1017-1025. 18. Hulka BS, Chambless LE, Deubner DC, Wilkinson WE. Breast cancer and estrogen replacement therapy . Am J Obstet Gynecol. 1982;143:638-644. 19. Vakil DV, Morgan RW, Halliday M. Exogenous estrogens and develop ment of breast and endometrial cancer . Cancer Detect Prev. 1983;6:415-424. 20. Gambrell RD Jr, Maier RC, Sanders BI. Decreased incidence of breast cancer in postmenopausal estrogen-progestogen users . Obstet Gynecol. 1983;62:435-443. 21. Sherman B, Wallace R, Bean J. Estrogen use and breast cancer: interac tion with body mass . Cancer. 1983;51:1527-1531.Crossref 22. Kaufman DW, Miller DR, Rosenberg L, et al. Noncontraceptive estro gen use and the risk of breast cancer . JAMA. 1984;252:63-67.Crossref 23. Horwitz RI, Stewart KR. Effect of clinical features on the association of estrogens and breast cancer . Am J Med. 1984;76:192-198.Crossref 24. Hiatt RA, Bawol R, Friedman GD, Hoover R. Exogenous estrogen and breast cancer after bilateral oophorectomy . Cancer. 1984;54:139-144.Crossref 25. Nomura AMY, Kolonel LN, Hirohata T, Lee J. The association of replacement estrogens with breast cancer . Int J Cancer. 1986;37:49-53.Crossref 26. McDonald JA, Weiss NS, Daling JR, Francis AM, Polissar L. Menopaus al estrogen use and the risk of breast cancer . Breast Cancer Res Treat. 1986;7:193-199.Crossref 27. Brinton LA, Hoover R, Fraumeni JF Jr. Menopausal oestrogens and breast cancer risk: an expanded case-control study . Br J Cancer. 1986;54:825-832.Crossref 28. Buring JE, Hennekens CH, Lipnick RJ, et al. A prospective cohort study of postmenopausal hormone use and risk of breast cancer in US women . Am J Epidemiol. 1987;125:939-947. 29. Wingo PA, Layde PM, Lee NC, Rubin G, Ory HW. The risk of breast cancer in postmenopausal women who have used estrogen replacement thera py . JAMA. 1987;257:209-215.Crossref 30. Hunt K, Vessey M, McPherson K, Coleman M. Long-term surveillance of mortality and cancer incidence in women receiving hormone replacement therapy . Br J Obstet Gynecol. 1987;94:620-635.Crossref 31. Rohan TE, McMichael AJ. Non-contraceptive exogenous oestrogen therapy and breast cancer . Med J Aust. 1988;148:217-221. 32. Dupont WD, Page DL, Rogers LW, Parl FF. Influence of exogenous estrogens, proliferative breast disease, and other variables on breast cancer risk . Cancer. 1989;63:948-957.Crossref 33. Mills PK, Beeson WL, Phillips RL, Fraser GE. Prospective study of exogenous hormone use and breast cancer in Seventh-Day Adventists . Cancer. 1989;64:591-597.Crossref 34. Bergkvist L, Adami HO, Persson I, Hoover R, Schairer C. The risk of breast cancer after estrogen and estrogen-progestin replacement . N Engl J Med. 1989;321:293-297.Crossref 35. Boston Collaborative Drug Surveillance Program. Surgically confirmed gallbladder disease, venous thromboembolism, and breast tumors in relation to postmenopausal estrogen therapy . N Engl J Med. 1974;290:15-19.Crossref 36. Hammond CB, Jelovsek FR, Lee KL, Creasman WT, Parker RT. Effects of long-term estrogen replacement therapy, II: neoplasia . Am J Obstet Gynecol. 1979;133:537-547. 37. Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy, II: a prospective study in the relationship to carcinoma and cardiovascular and metabolic problems . Obstet Gynecol. 1979;54:74-79.Crossref 38. Wallach S, Henneman PH. Prolonged estrogen therapy in postmeno pausal women . JAMA. 1959;171:1637-1642.Crossref 39. Wilson RA. The roles of estrogen and progesterone in breast and genital cancer . JAMA. 1962;182:327-331.Crossref 40. Mustacchi P, Gordon GS. Frequency of cancer in estrogen-treated osteoporotic women . In: Segaloff A, ed. Breast Cancer: The Second Biennial Louisi ana Cancer Conference, New Orleans, Jan. 22-23, 1958 . St Louis, Mo: CV Mosby Co; 1958:163-169. 41. Brinton LA, Williams RR, Hoover RN, Stegens NL, Feinleib M, Fraumeni JF Jr. Breast cancer risk factors among screening program participants . J Natl Cancer Inst. 1979;62:37-44. 42. Brinton LA, Hoover RN, Szklo M, Fraumeni JF Jr. Menopausal estro gen use and risk of breast cancer . Cancer. 1981;47:2517-2522.Crossref 43. Bland KI, Buchanan JB, Weisberg BF, Hagan TA, Gray LA Sr. The effects of exogenous estrogen replacement therapy of the breast: breast cancer risk and mammographic parenchymal patterns . Cancer. 1980;45:3027-3033.Crossref 44. Gambrell RD, Massey FM, Castaneda TA, Boddie AW. Estrogen thera py and breast cancer in postmenopausal women . J Am Geriatr Soc. 1980;28:251-257. 45. Gambrell RD. Role of hormones in the etiology and prevention of endometrial and breast cancer . Acta Obstet Gynecol Scand Suppl. 1982;106:37-46.Crossref 46. Gambrell RD Jr. Hormones in the etiology and prevention of breast and endometrial cancer . South Med J. 1984;77:1509-1515.Crossref 47. Nomura AM, Hirohata T, Kolonel LN, Hankin JH, Lee J, Stemmer mann G. Breast cancer in Caucasian and Japanese women in Hawaii . Natl Cancer Inst Monogr. 1985;69:191-196. 48. Burch JC, Byrd BF Jr, Vaughn WK. The effects of long-term estrogen on hysterectomized women . Am J Obstet Gynecol. 1974;118:778-782. 49. Byrd BF Jr, Burch JC, Vaughn WK. Significance of postoperative estrogen therapy on the occurrence and clinical course of cancer . Ann Surg. 1973;177:626-631. 50. Burch JC, Byrd BF Jr. Effects of long-term administration of estrogen on the occurrence of mammary cancer in women . Ann Surg. 1971;174:414-418.Crossref 51. Henderson BE, Powell D, Rosario I, et al. An epidemiologic study of breast cancer . J Natl Cancer Inst. 1974;53:609-614. 52. Arthes FG, Sartwell PE, Lewison EF. The pill, estrogens, and the breast . Cancer. 1971;28:1391-1394.Crossref 53. Lawson DH, Jick H, Hunter JR, Madsen S. Exogenous estrogens and breast cancer . Am J Epidemiol. 1981;114:710-713. 54. Sartwell PE, Arthes FG, Tonascia JA. Exogenous hormones, reproduc tive history, and breast cancer . J Natl Cancer Inst. 1977;59:1589-1592. 55. LaVecchia C, DeCarli A, Parazzini F, Gentile A, Liberati C, Franceschi S. Non-contraceptive oestrogens and the risk of breast cancer in women . Br J Cancer. 1986;38:853-858. 56. Craig TJ, Comstock GW, Geiser PB. Epidemiologic comparison of breast cancer patients with early and late onset of malignancy and general population controls . J Natl Cancer Inst. 1974;53:1577-1581. 57. Dupont WD, Page DL. Letter to the editor . Cancer. 1990;65:1261-1262.Crossref 58. Dupont WD, Page DL. L'oestrogenotherapie substitutive accroit-elle le risque de cancer du sein? Contracept Fertil Sex. 1990;18:115-119. 59. Feinglos SJ. MEDLINE: A Basic Guide to Searching . Chicago, Ill: Medical Library Association; 1985. 60. Greenland S. Quantitative methods in the review of epidemiologic litera ture . Epidemiol Rev. 1987;9:1-30. 61. Breslow NE, Day NE. Statistical Methods in Cancer Research. Lyon, France: IARC Scientific Publications; 1980:134,146-152. 62. Rao CR. Linear Statistical Inference and Its Applications . 2nd ed. New York, NY: John Wiley & Sons Inc; 1973:426. 63. Mantel N. Chi-square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure . J Am Stat Assoc. 1963;58:690-700. 64. Key TJA, Pike MC. The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer . Eur J Cancer Clin Oncol. 1988;24:29-43.Crossref 65. Anderson TJ, Ferguson DJP, Raab GM. Cell turnover in the 'resting' human breast: influence of parity, contraceptive pill, age and laterality . Br J Cancer. 1982;46:376-382.Crossref 66. Kennedy DL, Baum C, Forbes MB. Noncontraceptive estrogens and progestins: use patterns over time . Obstet Gynecol. 1985;65:441-446. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Menopausal Estrogen Replacement Therapy and Breast Cancer

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References (83)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400010089011
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Abstract

Abstract We conducted a meta-analysis of the literature concerning breast cancer and estrogen replacement therapy. The overall relative risk of breast cancer associated with this therapy was 1.07. However, the variation of the estimated risks among the studies was far greater than could plausibly be explained by chance alone. To explain this variation, we looked at the effects of type, duration, and dosage of treatment. Overall, women who took 0.625 mg/d or less of conjugated estrogens had a risk of breast cancer that was 1.08 times that of women who did not receive this therapy (95% confidence interval [CI], 0.96 to 1.2). The relative risks from these individual studies of low-dosage therapy did not differ significantly from each other. Women who took 1.25 mg/d or more of conjugated estrogens had a breast cancer relative risk of 2.0 or less in all studies. However, the variation in observed risks at this higher dosage was significant. This implies that other risk factors varied among these studies, making it difficult to estimate the overall risk associated with this dosage. The relative risk of breast cancer associated with estro gen replacement therapy among women with a history of benign breast disease was 1.16 (95% CI, 0.89 to 1.5). The combined results from multiple studies provide strong evidence that meno pausal therapy consisting of 0.625 mg/d or less of conjugated estrogens does not increase breast cancer risk. (Arch Intern Med. 1991;151:67-72) References 1. References 5,6, 9-26, 28-34, 39, 40,43-45, 51-53. 2. References 4,7, 8,27,35-38,41,42,46-50. 3. References 4-7,10-12,14,17,20-22, 27, 31. 4. Council on Scientific Affairs. Estrogen replacement in the menopause . JAMA. 1983;249:359-361.Crossref 5. Bush TL, Barrett-Connor E. Noncontraceptive estrogen use and cardio vascular disease . Epidemiol Rev. 1985;7:80-104. 6. Kelsey JL, Berkowitz GS. Breast cancer epidemiology . Cancer Res. 1988;48:5615-5623. 7. Mack TM, Henderson BE, Gerkins VR, Arthur M, Baptista J, Pike MC. Reserpine and breast cancer in a retirement community . N Engl J Med. 1975;292:1366-1371.Crossref 8. Hoover R, Gray LA Sr, Cole P, MacMahon B. Menopausal estrogens and breast cancer . N Engl J Med. 1976;295:401-405.Crossref 9. Casagrande J, Gerkins V, Henderson BE, Mack T, Pike MC. Brief communication: exogenous estrogens and breast cancer in women with natural menopause . J Natl Cancer Inst. 1976;56:839-841. 10. Byrd BF Jr, Burch JC, Vaughn WK. The impact of long term estrogen support after hysterectomy . Ann Surg. 1977;185:574-579.Crossref 11. Wynder EL, MacCornack FA, Stellman SD. The epidemiology of breast cancer in 785 United States Caucasian women . Cancer. 1978;41:2341-2354.Crossref 12. Ravnihar B, Seigel DG, Lindtner J. An epidemiologic study of breast cancer and benign breast neoplasias in relation to the oral contraceptive and estrogen use . Eur J Cancer Clin Oncol. 1979;15:395-405. 13. Jick H, Walker AM, Watkins RN, et al. Replacement estrogens and breast cancer . Am J Epidemiol. 1980;112:586-594. 14. Ross RK, Paganini-Hill A, Gerkins VR, et al. A case-control study of menopausal estrogen therapy and breast cancer . JAMA. 1980;243:1635-1639.Crossref 15. Hoover R, Glass A, Finkle WD, Azevedo D, Milne K. Conjugated estrogens and breast cancer risk in women . J Natl Cancer Inst. 1981;67:815-820. 16. Kelsey JL, Fischer DB, Holford TR, et al. Exogenous estrogens and other factors in the epidemiology of breast cancer . J Natl Cancer Inst. 1981;67:327-333. 17. Thomas DB, Persing JP, Hutchinson WB. Exogenous estrogens and other risk factors for breast cancer in women with benign breast disease . J Natl Cancer Inst. 1982;69:1017-1025. 18. Hulka BS, Chambless LE, Deubner DC, Wilkinson WE. Breast cancer and estrogen replacement therapy . Am J Obstet Gynecol. 1982;143:638-644. 19. Vakil DV, Morgan RW, Halliday M. Exogenous estrogens and develop ment of breast and endometrial cancer . Cancer Detect Prev. 1983;6:415-424. 20. Gambrell RD Jr, Maier RC, Sanders BI. Decreased incidence of breast cancer in postmenopausal estrogen-progestogen users . Obstet Gynecol. 1983;62:435-443. 21. Sherman B, Wallace R, Bean J. Estrogen use and breast cancer: interac tion with body mass . Cancer. 1983;51:1527-1531.Crossref 22. Kaufman DW, Miller DR, Rosenberg L, et al. Noncontraceptive estro gen use and the risk of breast cancer . JAMA. 1984;252:63-67.Crossref 23. Horwitz RI, Stewart KR. Effect of clinical features on the association of estrogens and breast cancer . Am J Med. 1984;76:192-198.Crossref 24. Hiatt RA, Bawol R, Friedman GD, Hoover R. Exogenous estrogen and breast cancer after bilateral oophorectomy . Cancer. 1984;54:139-144.Crossref 25. Nomura AMY, Kolonel LN, Hirohata T, Lee J. The association of replacement estrogens with breast cancer . Int J Cancer. 1986;37:49-53.Crossref 26. McDonald JA, Weiss NS, Daling JR, Francis AM, Polissar L. Menopaus al estrogen use and the risk of breast cancer . Breast Cancer Res Treat. 1986;7:193-199.Crossref 27. Brinton LA, Hoover R, Fraumeni JF Jr. Menopausal oestrogens and breast cancer risk: an expanded case-control study . Br J Cancer. 1986;54:825-832.Crossref 28. Buring JE, Hennekens CH, Lipnick RJ, et al. A prospective cohort study of postmenopausal hormone use and risk of breast cancer in US women . Am J Epidemiol. 1987;125:939-947. 29. Wingo PA, Layde PM, Lee NC, Rubin G, Ory HW. The risk of breast cancer in postmenopausal women who have used estrogen replacement thera py . JAMA. 1987;257:209-215.Crossref 30. Hunt K, Vessey M, McPherson K, Coleman M. Long-term surveillance of mortality and cancer incidence in women receiving hormone replacement therapy . Br J Obstet Gynecol. 1987;94:620-635.Crossref 31. Rohan TE, McMichael AJ. Non-contraceptive exogenous oestrogen therapy and breast cancer . Med J Aust. 1988;148:217-221. 32. Dupont WD, Page DL, Rogers LW, Parl FF. Influence of exogenous estrogens, proliferative breast disease, and other variables on breast cancer risk . Cancer. 1989;63:948-957.Crossref 33. Mills PK, Beeson WL, Phillips RL, Fraser GE. Prospective study of exogenous hormone use and breast cancer in Seventh-Day Adventists . Cancer. 1989;64:591-597.Crossref 34. Bergkvist L, Adami HO, Persson I, Hoover R, Schairer C. The risk of breast cancer after estrogen and estrogen-progestin replacement . N Engl J Med. 1989;321:293-297.Crossref 35. Boston Collaborative Drug Surveillance Program. Surgically confirmed gallbladder disease, venous thromboembolism, and breast tumors in relation to postmenopausal estrogen therapy . N Engl J Med. 1974;290:15-19.Crossref 36. Hammond CB, Jelovsek FR, Lee KL, Creasman WT, Parker RT. Effects of long-term estrogen replacement therapy, II: neoplasia . Am J Obstet Gynecol. 1979;133:537-547. 37. Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy, II: a prospective study in the relationship to carcinoma and cardiovascular and metabolic problems . Obstet Gynecol. 1979;54:74-79.Crossref 38. Wallach S, Henneman PH. Prolonged estrogen therapy in postmeno pausal women . JAMA. 1959;171:1637-1642.Crossref 39. Wilson RA. The roles of estrogen and progesterone in breast and genital cancer . JAMA. 1962;182:327-331.Crossref 40. Mustacchi P, Gordon GS. Frequency of cancer in estrogen-treated osteoporotic women . In: Segaloff A, ed. Breast Cancer: The Second Biennial Louisi ana Cancer Conference, New Orleans, Jan. 22-23, 1958 . St Louis, Mo: CV Mosby Co; 1958:163-169. 41. Brinton LA, Williams RR, Hoover RN, Stegens NL, Feinleib M, Fraumeni JF Jr. Breast cancer risk factors among screening program participants . J Natl Cancer Inst. 1979;62:37-44. 42. Brinton LA, Hoover RN, Szklo M, Fraumeni JF Jr. Menopausal estro gen use and risk of breast cancer . Cancer. 1981;47:2517-2522.Crossref 43. Bland KI, Buchanan JB, Weisberg BF, Hagan TA, Gray LA Sr. The effects of exogenous estrogen replacement therapy of the breast: breast cancer risk and mammographic parenchymal patterns . Cancer. 1980;45:3027-3033.Crossref 44. Gambrell RD, Massey FM, Castaneda TA, Boddie AW. Estrogen thera py and breast cancer in postmenopausal women . J Am Geriatr Soc. 1980;28:251-257. 45. Gambrell RD. Role of hormones in the etiology and prevention of endometrial and breast cancer . Acta Obstet Gynecol Scand Suppl. 1982;106:37-46.Crossref 46. Gambrell RD Jr. Hormones in the etiology and prevention of breast and endometrial cancer . South Med J. 1984;77:1509-1515.Crossref 47. Nomura AM, Hirohata T, Kolonel LN, Hankin JH, Lee J, Stemmer mann G. Breast cancer in Caucasian and Japanese women in Hawaii . Natl Cancer Inst Monogr. 1985;69:191-196. 48. Burch JC, Byrd BF Jr, Vaughn WK. The effects of long-term estrogen on hysterectomized women . Am J Obstet Gynecol. 1974;118:778-782. 49. Byrd BF Jr, Burch JC, Vaughn WK. Significance of postoperative estrogen therapy on the occurrence and clinical course of cancer . Ann Surg. 1973;177:626-631. 50. Burch JC, Byrd BF Jr. Effects of long-term administration of estrogen on the occurrence of mammary cancer in women . Ann Surg. 1971;174:414-418.Crossref 51. Henderson BE, Powell D, Rosario I, et al. An epidemiologic study of breast cancer . J Natl Cancer Inst. 1974;53:609-614. 52. Arthes FG, Sartwell PE, Lewison EF. The pill, estrogens, and the breast . Cancer. 1971;28:1391-1394.Crossref 53. Lawson DH, Jick H, Hunter JR, Madsen S. Exogenous estrogens and breast cancer . Am J Epidemiol. 1981;114:710-713. 54. Sartwell PE, Arthes FG, Tonascia JA. Exogenous hormones, reproduc tive history, and breast cancer . J Natl Cancer Inst. 1977;59:1589-1592. 55. LaVecchia C, DeCarli A, Parazzini F, Gentile A, Liberati C, Franceschi S. Non-contraceptive oestrogens and the risk of breast cancer in women . Br J Cancer. 1986;38:853-858. 56. Craig TJ, Comstock GW, Geiser PB. Epidemiologic comparison of breast cancer patients with early and late onset of malignancy and general population controls . J Natl Cancer Inst. 1974;53:1577-1581. 57. Dupont WD, Page DL. Letter to the editor . Cancer. 1990;65:1261-1262.Crossref 58. Dupont WD, Page DL. L'oestrogenotherapie substitutive accroit-elle le risque de cancer du sein? Contracept Fertil Sex. 1990;18:115-119. 59. Feinglos SJ. MEDLINE: A Basic Guide to Searching . Chicago, Ill: Medical Library Association; 1985. 60. Greenland S. Quantitative methods in the review of epidemiologic litera ture . Epidemiol Rev. 1987;9:1-30. 61. Breslow NE, Day NE. Statistical Methods in Cancer Research. Lyon, France: IARC Scientific Publications; 1980:134,146-152. 62. Rao CR. Linear Statistical Inference and Its Applications . 2nd ed. New York, NY: John Wiley & Sons Inc; 1973:426. 63. Mantel N. Chi-square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure . J Am Stat Assoc. 1963;58:690-700. 64. Key TJA, Pike MC. The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer . Eur J Cancer Clin Oncol. 1988;24:29-43.Crossref 65. Anderson TJ, Ferguson DJP, Raab GM. Cell turnover in the 'resting' human breast: influence of parity, contraceptive pill, age and laterality . Br J Cancer. 1982;46:376-382.Crossref 66. Kennedy DL, Baum C, Forbes MB. Noncontraceptive estrogens and progestins: use patterns over time . Obstet Gynecol. 1985;65:441-446.

Journal

Archives of Internal Medicine – American Medical Association

Published: Jan 1, 1991

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