Abstract
Controlled studies and most observational studies published over the last 5 years suggest that the addition of synthetic progestins to estrogen in hormone replacement therapy (HRT), particularly in continuous-combined regimen, increases the breast cancer (BC) risk compared to estrogen alone. By contrast, a recent study suggests that the addition of natural progesterone in cyclic regimens does not affect BC risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. The increased BC risk found with the addition of synthetic progestins to estrogen could be due to the regimen and/or the kind of progestin used. Continuous-combined regimen inhibits the sloughing of mammary epithelium that occurs after progesterone withdrawal in a cyclic regimen. More importantly, the progestins used (medroxyprogesterone acetate and 19-Nortestosterone-derivatives) are endowed with some non-progesterone-like effects, which can potentiate the proliferative action of estrogens. Particularly relevant seem to be the metabolic and hepatocellular effects (decreased insulin sensitivity, increased levels and activity of insulin-like growth factor-I, and decreased levels of SHBG), which contrast the opposite effects induced by oral estrogen.
| Original language | English |
|---|---|
| Pages (from-to) | 95-108 |
| Number of pages | 14 |
| Journal | Journal of Steroid Biochemistry and Molecular Biology |
| Volume | 96 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jul 2005 |
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Keywords
- Breast cancer
- Estrogen
- Hormone replacement therapy
- Insulin
- Insulin-like growth factor-I
- Progesterone
- Progestins
- Sex hormone binding globulin
ASJC Scopus subject areas
- Biochemistry
- Endocrinology
Cite this
Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. / Campagnoli, Carlo; Clavel-Chapelon, Françoise; Kaaks, Rudolf; Peris, Clementina; Berrino, Franco.
In: Journal of Steroid Biochemistry and Molecular Biology, Vol. 96, No. 2, 07.2005, p. 95-108.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Progestins and progesterone in hormone replacement therapy and the risk of breast cancer
AU - Campagnoli, Carlo
AU - Clavel-Chapelon, Françoise
AU - Kaaks, Rudolf
AU - Peris, Clementina
AU - Berrino, Franco
PY - 2005/7
Y1 - 2005/7
N2 - Controlled studies and most observational studies published over the last 5 years suggest that the addition of synthetic progestins to estrogen in hormone replacement therapy (HRT), particularly in continuous-combined regimen, increases the breast cancer (BC) risk compared to estrogen alone. By contrast, a recent study suggests that the addition of natural progesterone in cyclic regimens does not affect BC risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. The increased BC risk found with the addition of synthetic progestins to estrogen could be due to the regimen and/or the kind of progestin used. Continuous-combined regimen inhibits the sloughing of mammary epithelium that occurs after progesterone withdrawal in a cyclic regimen. More importantly, the progestins used (medroxyprogesterone acetate and 19-Nortestosterone-derivatives) are endowed with some non-progesterone-like effects, which can potentiate the proliferative action of estrogens. Particularly relevant seem to be the metabolic and hepatocellular effects (decreased insulin sensitivity, increased levels and activity of insulin-like growth factor-I, and decreased levels of SHBG), which contrast the opposite effects induced by oral estrogen.
AB - Controlled studies and most observational studies published over the last 5 years suggest that the addition of synthetic progestins to estrogen in hormone replacement therapy (HRT), particularly in continuous-combined regimen, increases the breast cancer (BC) risk compared to estrogen alone. By contrast, a recent study suggests that the addition of natural progesterone in cyclic regimens does not affect BC risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. The increased BC risk found with the addition of synthetic progestins to estrogen could be due to the regimen and/or the kind of progestin used. Continuous-combined regimen inhibits the sloughing of mammary epithelium that occurs after progesterone withdrawal in a cyclic regimen. More importantly, the progestins used (medroxyprogesterone acetate and 19-Nortestosterone-derivatives) are endowed with some non-progesterone-like effects, which can potentiate the proliferative action of estrogens. Particularly relevant seem to be the metabolic and hepatocellular effects (decreased insulin sensitivity, increased levels and activity of insulin-like growth factor-I, and decreased levels of SHBG), which contrast the opposite effects induced by oral estrogen.
KW - Breast cancer
KW - Estrogen
KW - Hormone replacement therapy
KW - Insulin
KW - Insulin-like growth factor-I
KW - Progesterone
KW - Progestins
KW - Sex hormone binding globulin
UR - http://www.scopus.com/inward/record.url?scp=23244452258&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=23244452258&partnerID=8YFLogxK
U2 - 10.1016/j.jsbmb.2005.02.014
DO - 10.1016/j.jsbmb.2005.02.014
M3 - Article
C2 - 15908197
AN - SCOPUS:23244452258
VL - 96
SP - 95
EP - 108
JO - Journal of Steroid Biochemistry and Molecular Biology
JF - Journal of Steroid Biochemistry and Molecular Biology
SN - 0960-0760
IS - 2
ER -