Use of the Levonorgestrel-Releasing Intrauterine System and Breast Cancer

Backman, Tiina; Rauramo, Ilkka; Jaakkola, Kimmo; Inki, Pirjo; Vaahtera, Katja; Launonen, Aino; Koskenvuo, Markku

doi:10.1097/01.aog.0000195970.65200.3e

Cited by 24 publications

(28 citation statements)

References 1 publication

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“…Anwenderinnen wiesen gegenüber Frauen ohne das Intrauterinpessar zwar keine signifikant erhöhte Brustkrebsinzidenz auf, doch war die Anzahl neu diagnostizierter Brustkrebserkrankungen in der Altersgruppe zwischen 35-39 Jahren bei der Gruppe der Anwenderinnen (nicht signifikant) erhöht im Vergleich mit Frauen ohne Intrauteripessar [18]. Hier sind weitere Studien notwendig.…”

Section: Ausschließlich Gestagenhaltige Kontrazeptivaunclassified

Hormonelle Kontrazeption und Brustkrebsrisiko

Bjelic‐Radisic

Petru

2010

Wien Med Wochenschr

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The largest meta-analysis comprised a total of 54 epidemiologic studies (Collaborative Group on Hormonal Factors in Breast Cancer) and included 53,297 women with breast cancer and 100,239 controls. Women currently using hormonal contraceptives had a modestly elevated risk for breast cancer (RR 1.24). This risk continuously decreased over years and did not exist after discontinuation of the drugs after ten years. Women who had started on contraceptives before the age of 20, had an elevated risk for breast cancer over the subsequent years (relative risk = RR 1.95 until the 30th year of age, RR 1.54 between 30 and 34 years, and RR 1.27 between the age of 35 and 40 years, respectively) compared to those who started to use contraceptives after 20 years of age. There was no difference in the risk between the different dosages, combined or gestagen-based contraceptives. However, the proportion of women using gestagens only was small. Study data on the effect of oral contraceptives in women with BRCA1/2 mutation or women with a positive familial history are controversial. A recently published systematic overview of 10 studies including a pooled analysis of 54 studies did not reveal an elevated breast cancer risk for women carrying an elevated breast cancer risk taking contraceptives.

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Section: Ausschließlich Gestagenhaltige Kontrazeptivaunclassified

Hormonelle Kontrazeption und Brustkrebsrisiko

Bjelic‐Radisic

Petru

2010

Wien Med Wochenschr

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“…Evidence for significant systemic levels are the side effects that are associated with the use of the LNG IUS. Patients using the LNG IUS have a relative risk of hypertension and gall bladder disease of 1.8 and 1.5, respectively, and other side effects include skin conditions, headache, upper limb neuropathies, dizziness, nervousness, malaise, minor visual disturbances, respiratory conditions, arthropathies, weight change, anxiety, and nonclinical depression (4,6,12).…”

Section: Trinh Lng Ius In Breast Cancer Patients Fertil Steril 2008mentioning

confidence: 99%

“…A recent epidemiologic study in Finland found no increase in the incidence of breast cancer in LNG IUS users compared with in nonusers (4). This study was based on a questionnaire sent to LNG IUS users, of whom 77.6% responded.…”

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confidence: 93%

Use of the levonorgestrel-releasing intrauterine system in breast cancer patients

Trinh

Tjalma

Makar

et al. 2008

Fertility and Sterility

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“…Also in another epidemiological study [20], investigating the rate of breast cancer in users of levonorgestrel-containing intrauterine device (LNG-IUD) compared to the general population, the subgroups of device users aged 35-39 years showed a higher number of breast cancer cases per 100 000 women years than the general population, 74 cases versus 49.2 (regardless of significant study limitations which might have lowered the estimated risk).…”

Section: Hormonal Contraception (Epidemiological Studies)mentioning

confidence: 99%

Progestin and breast cancer

Giersig

2008

Bundesgesundheitsbl.

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The previous assumption that progestin does not promote breast cancer development needs to be re-examined since a growing body of evidence indicates the opposite. Data from recent experimental trials and results from clinical and epidemiological studies on hormonal contraceptives and hormone replacement therapy (HRT) have been confronted with breast cancer cases known from the German database of adverse drug reactions (ADR), reported in association with the use of progestin only contraceptives (POC) and combined oral contraceptives (COC). Also cases reported in association with HRT have been analysed. The available data complement one another showing a tumour promoting potential of progestin, possibly higher than that of a combination of estrogen and progestin. These assumptions are based on the following facts: 1) in estrogen-supplemented animals, progesterone has been shown to reactivate the growth of regressed tumour xenograft obtained from breast cancer cell lines, expressing both estrogen and progesterone receptor; 2) antiprogestin has been revealed to suppress the reactivation of the growth of tumour xenograft and to fully suppress the development of breast cancer in an animal model for BRCA1 gene mutation; 3) metabolites of progesterone have been recognised as potent regulators of cell proliferation, cell detachment and apoptosis; 4) progesterone has been shown to inhibit, in a dose-dependent manner, apoptosis in breast cancer cell lines and apoptosis induced by doxorubicin and 5-fluorouracyl (drugs used in breast cancer treatment); 5) an association between breast cancer and HRT was suspected upon the addition of progestin on a regular basis for the prevention of endometrial cancer; 6) in a randomised placebo-controlled trial on HRT an increased risk of breast cancer was shown for the combination of estrogen and progestin, but not for estrogen alone; 7) in epidemiological studies on POC the recognition of an increased breast cancer risk was most probably impeded due to previously unrecognised systematic selection bias; 8) in a large epidemiological study on the risk of early-onset breast cancer in association with COC an increased risk was detected for COC use up to 1975, but no increased, even a slightly decreased, risk was shown for users of low-dose COC, applied since 1976; 9) a considerably higher number of breast cancer cases have been reported from Germany on POC than on the widespread used COC [corrected] (111 versus 12); 10) the big resemblance among the breast cancers reported for POC and their similarity with breast malignancies diagnosed in pregnancy suggest the existence of a pattern rather than pure coincidence [corrected]

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Use of the Levonorgestrel-Releasing Intrauterine System and Breast Cancer

Cited by 24 publications

References 1 publication

Hormonelle Kontrazeption und Brustkrebsrisiko

Hormonelle Kontrazeption und Brustkrebsrisiko

Use of the levonorgestrel-releasing intrauterine system in breast cancer patients

Progestin and breast cancer

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