Thank you!  I have a student asking me about this, and I'm not on top of
the literature right now.  So, again, thanks very much, Alison.

Joan:

These might help.  Several are available in full text on PubMed.

Best,
  Alison

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Br J Cancer. 2005 Mar 22

Hormone use for menopausal symptoms and risk of breast cancer. A Danish
cohort study.

Ewertz M, Mellemkjaer L, Poulsen AH, Friis S, Sorensen HT, Pedersen L,
McLaughlin JK, Olsen JH.

1Department of Oncology, Aalborg Hospital, Aarhus University, Hobrovej
18-22, PO Box 365, DK-9100 Aalborg, Denmark.

Numerous studies and meta-analyses have shown that hormone replacement
therapy (HRT) for menopausal symptoms increases the risk of developing
breast cancer, estimated to be 2.3% for each year of use. The influence of
different oestrogen-progestin regimens has still not been fully evaluated.
Using longitudinal data from the population-based prescription database of
the county of North Jutland, Denmark, and the Danish Cancer Registry, we
examined the risk of developing breast cancer in relation to HRT in a cohort
of 78 380 women aged 40-67 years from 1989 to 2002. A total of 1462 cases of
breast cancer were identified during a mean follow-up of 10 years. Use of
HRT did not increase the risk of breast cancer in women aged 40-49 years.
Restricting the cohort to 48 812 women aged 50 years or more at entry, of
whom 15 631 were HRT users, we found an increased risk associated with
current use of HRT (relative risk 1.61, 95% confidence interval 1.38-1.88).
The risk increased with increasing duration of use and decreased with time
since last HRT prescription, reaching unity after 5 years. No material risk
difference was observed among the various HRT-regimens. This
population-based cohort study provides further confirmation that HRT
increases the risk of developing breast cancer in women aged 50 years or
more.British Journal of Cancer advance online publication, 22 March 2005;
doi:10.1038/sj.bjc.6602472 www.bjcancer.com.

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J Natl Cancer Inst Monogr. 2005;(34):83-6.
Reproductive Issues for Women With BRCA Mutations.

Friedman LC, Kramer RM.

Baylor College of Medicine, The Menninger Department of Psychiatry and
Behavioral Sciences, One Baylor Plaza, Houston, TX 77030. [log in to unmask]

Women carrying BRCA1 and BRCA2 mutations face difficult and confusing
reproductive decisions that fall into three categories: issues relating to
risk-reducing surgeries, issues relating to use of oral contraceptives/tubal
ligation, and issues relating to pregnancy and breastfeeding. Risk-reducing
surgeries may confer survival benefits, but they also affect quality of
life. Oral contraceptives potentially protect mutation carriers against
ovarian cancer but increase the risk of early-onset breast cancer, and
evidence for the efficacy of tubal ligation in reducing ovarian cancer risk
in BRCA mutation carriers is contradictory. Women with BRCA mutations may
increase their risk of breast cancer by becoming pregnant before age 40
years, but breastfeeding may decrease risk of breast cancer in women with
BRCA mutations, regardless of age. BRCA mutation carriers desiring to become
pregnant must deal with a variety of psychosocial issues, some with
significant ethical implications, with minimal guidance from research.

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Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):350-6.

Oral contraceptive use and risk of early-onset breast cancer in carriers and
noncarriers of BRCA1 and BRCA2 mutations.

Milne RL, Knight JA, John EM, Dite GS, Balbuena R, Ziogas A, Andrulis IL,
West DW, Li FP, Southey MC, Giles GG, McCredie MR, Hopper JL, Whittemore AS.

Centre for Genetic Epidemiology, The University of Melbourne, Level 2, 723
Swanston Street, Carlton, Victoria 3053, Australia. [log in to unmask]

BACKGROUND: Recent oral contraceptive use has been associated with a small
increase in breast cancer risk and a substantial decrease in ovarian cancer
risk. The effects on risks for women with germ line mutations in BRCA1 or
BRCA2 are unclear.METHODS: Subjects were population-based samples of
Caucasian women that comprised 1,156 incident cases of invasive breast
cancer diagnosed before age 40 (including 47 BRCA1 and 36 BRCA2 mutation
carriers) and 815 controls from the San Francisco Bay area, California,
Ontario, Canada, and Melbourne and Sydney, Australia. Relative risks by
carrier status were estimated using unconditional logistic regression,
comparing oral contraceptive use in case groups defined by mutation status
with that in controls.RESULTS: After adjustment for potential confounders,
oral contraceptive use for at least 12 months was associated with decreased
breast cancer risk for BRCA1 mutation carriers [odds ratio (OR), 0.22; 95%
confidence interval (CI), 0.10-0.49; P < 0.001], but not for BRCA2 mutation
carriers (OR, 1.02; 95% CI, 0.34-3.09) or noncarriers (OR, 0.93; 95% CI,
0.69-1.24). First use during or before 1975 was associated with increased
risk for noncarriers (OR, 1.52 per year of use before 1976; 95% CI,
1.22-1.91; P < 0.001).CONCLUSIONS: There was no evidence that use of current
low-dose oral contraceptive formulations increases risk of early-onset
breast cancer for mutation carriers, and there may be a reduced risk for
BRCA1 mutation carriers. Because current formulations of oral contraceptives
may reduce, or at least not exacerbate, ovarian cancer risk for mutation
carriers, they should not be contraindicated for a woman with a germ line
mutation in BRCA1 or BRCA2.

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Bulletin du Cancer. 2004 Jul-Aug;91(7-8):583-91

[Are the hereditary forms of BRCA1 and BRCA2 breast cancer sensitive to
estrogens?]

[Article in French]

Pujol P, This P, Noruzinia M, Stoppa-Lyonnet D, Maudelonde T.

Service de biologie cellulaire et hormonale, CHU de Montpellier, 34295
Montpellier, FRANCE. [log in to unmask]

There is emerging evidence from clinical and experimental data that familial
breast cancers, including BRCA1 and BRCA2 related forms, could be in fact
estrogen-sensitive. Interactions between BRCA1 gene expression and estrogens
have been reported. On one hand, BRCA1 expression could be induced by
estradiol in experimental models. On the other hand, recent studies indicate
that BRCA 1 interacts with and regulates the activity of estrogen receptor
ERalpha. Endogenous or exogenous estrogens, such as oral contraceptive, may
also increase the risk of breast cancer in BRCA1 mutation carriers in
clinical studies. Conversely, prophylactic oophorectomy and anti-estrogens
may decrease the risk of familial breast cancer. Prospective studies are
thus required to estimate the potential benefits of estrogen suppression
therapies for prevention or adjuvant treatment of familial breast cancer.
Oral contraception and hormonal replacement therapy after menopause should
be used with caution in BRCA1 or BRCA2 mutation carriers. Copyright John
Libbey Eurotext 2003.


----- Original Message -----
From: "Joan Callahan" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, April 02, 2005 4:28 PM
Subject: breast cancer and "the pills"


>Does anyone have any good recent references on the relation between breast
>cancer and oral contraceptives / HRT?
>
>thanks,
>Joan