Uso da terapia de reposição hormonal no climatério e a associação com o câncer de mama
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Publicado
Nov 18, 2024
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Resumo
Objetivo: Determinar quais são os fatores de risco associados ao aparecimento de câncer de mama (CM) em mulheres que realizam terapia hormonal no climatério (TRH). Métodos: Revisão integrativa da literatura científica realizada através de busca sistemática nas bases de evidências da Literatura LILACS e PUBMED entre os anos 2018 e 2023. Foram encontrados 15 artigos para pesquisa. Resultados: O uso da TRH está associado ao aumento na incidência de CM, sendo estes riscos agravados por fatores associados à administração dos hormônios e riscos individuais. A incidência aumenta quanto maior a duração da reposição e proporcionalmente com a idade de início. A utilização de estrogênios vaginais tem o menor risco entre as opções, já o uso de estrogênio isolado via transdérmica ou oral apresentam menor incidência de CM do que o uso por mesma via das formulações combinadas de estrogênio e progesterona, principalmente progestágenos sintéticos. Assim como, o ganho de peso na pós-menopausa está mais associado ao risco de CM. Considerações finais: Todos os tipos de TH, exceto estrogênios vaginais, estão associados a mais incidência de câncer de mama, principalmente a combinação de estrogênio e progestagênio, especialmente em mulheres magras. Avaliação individual de risco-benefício é essencial antes da TRH para sintomas climatéricos.
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Como Citar
SantosG. N. O., CandidoI. E., & RoccaR. R. (2024). Uso da terapia de reposição hormonal no climatério e a associação com o câncer de mama. Revista Eletrônica Acervo Saúde, 24(11), e17722. https://doi.org/10.25248/reas.e17722.2024
Seção
Revisão Bibliográfica
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Referências
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12. GERTIG DM, et al. Hormone therapy and breast cancer: what factors modify the association?. Menopause, 2006; 13(2): 178–184.
13. GRACIA CR e FREEMAN EW. Onset of the Menopause Transition: The Earliest Signs and Symptoms. Obstetrics and Gynecology Clinics of North America, 2018; 45(4): 585–597.
14. GRAM MA, et al. Associations of body fat mass and fat-free mass with breast cancer incidence in postmenopausal women: A Danish prospective cohort study. Annals of Epidemiology, 2023.
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16. JIANG Y, et al. Breast cancer incidence and mortality in relation to hormone replacement therapy use among postmenopausal women: results from a prospective cohort study. Clinical Breast Cancer, 2021.
17. LAMBRINOUDAKI I, et al. Menopause, wellbeing and health: A care pathway from the European Menopause and Andropause Society. Maturitas, 2022; 163: 1–14.
18. MARTINS SC, et al. Hormone Therapy and Breast Cancer: a literature review about the influence of hormonal treatment on neoplastic development. REVISTA MÉDICA DE MINAS GERAIS, 2021; 31.
19. MEHTA J, et al. Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts. Frontiers in Endocrinology, 2021; 12.
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23. PRENTICE RL, et al. Randomized Trial Evaluation of the Benefits and Risks of Menopausal Hormone Therapy Among Women 50-59 Years of Age. American Journal of Epidemiology, 2021; 190(3): 365–375.
24. RANGER TA, et al. Hormone replacement therapy and cancer survival: a longitudinal cohort study: protocol paper. BMJ Open, 2021; 11(8): 046701.
25. SALAGAME U, et al. Menopausal Hormone Therapy use and breast cancer risk by receptor subtypes: Results from the New South Wales Cancer Lifestyle and EvaluAtion of Risk (CLEAR) study. PLOS ONE, 2018; 13(11): 02050347.
26. SANDVEI MS, et al. Menopausal hormone therapy and breast cancer risk: effect modification by body mass through life. European Journal of Epidemiology, 2018; 34(3): 267–278.
27. SANTORO N, et al. The Menopause Transition: Signs, Symptoms, and Management Options. The Journal of Clinical Endocrinology & Metabolism, 2020; 106(1): 1–15.
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29. SHIFREN JL e GASS MLS. The North American Menopause Society Recommendations for Clinical Care of Midlife Women. Menopause, 2014; 21(10): 1038–1062.
30. TAVARES DSM, et al. Revisão integrativa: o que é e como fazer Integrative review: what is it? How to do it? Einstein, 2010; 8(1): 102–108.
31. THE WOMEN’S HEALTH INITIATIVE STUDY GROUP. Design of the Women’s Health Initiative Clinical Trial and Observational Study. Controlled Clinical Trials, 1988; 19(1): 61–109.
32. TK Y, et al. Hormone Replacement Therapy, Breast Cancer Risk Factors, and Breast Cancer Risk: A Nationwide Population-Based Cohort. Cancer Epidemiol Biomarkers Prev. 2020; 29(7): 1341-1347.
33. VAN DEN BRANDT PA, et al. Body size and weight change over adulthood and risk of breast cancer by menopausal and hormone receptor status: a pooled analysis of 20 prospective cohort studies. European Journal of Epidemiology, 2022; 36(1): 37–55.
34. WANG SM, et al. Use of postmenopausal hormone therapies and risk of histology- and hormone receptor-defined breast cancer: results from a 15-year prospective analysis of NIH-AARP cohort. Breast Cancer Research, 2020; 22(1).
35. WANG X, et al. Genome-wide interaction analysis of menopausal hormone therapy use and breast cancer risk among 62,370 women. Scientific Reports, 2022; 12(1).
36. WRITING GROUP FOR THE WOMEN'S HEALTH INITIATIVE INVESTIGATORS. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA: The Journal of the American Medical Association, 2002; 288(3): 321–333.
37. YEO SK e GUAN JL. Breast Cancer: Multiple Subtypes within a Tumor? Trends in Cancer, 2017; 3(11): 753–760.
2. BERAL V, et al. Menopausal hormone therapy and 20-year breast cancer mortality. The Lancet, 2019; 394(10204): 1139.
3. CAGNACCI A e VENIER M. The Controversial History of Hormone Replacement Therapy. Medicina, 2019; 55: 9.
4. CAO Y, et al. Association of body fat distribution and risk of breast cancer in pre- and postmenopausal women. Obesity Facts, 2023.
5. CHLEBOWSKI RT, et al. Association of Menopausal Hormone Therapy With Breast Cancer Incidence and Mortality During Long-term Follow-up of the Women’s Health Initiative Randomized Clinical Trials. JAMA, 2020; 324(4): 369–380.
6. COLLABORATIVE GROUP ON HORMONAL FACTORS IN BREAST CANCER. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. The Lancet, 2019; 394(10204): 1159–1168.
7. COMISSÃO NACIONAL ESPECIALIZADA EM CLIMATÉRIO DA FEDERAÇÃO BRASILEIRA DAS ASSOCIAÇÕES DE GINECOLOGIA E OBSTETRÍCIA (FEBRASGO). FEBRASGO POSITION STATEMENT, 2022; 5. Disponível em: https ://www.febrasgo.org.br/images/pec/posicionamentos-febrasgo/FPS-N5-Maio2022portugues.pd. Acesso em 22 de set. de 2023.
8. DENG Y, et al. Identification of Candidate Genes in Breast Cancer Induced by Estrogen Plus Progestogens Using Bioinformatic Analysis. International Journal of Molecular Sciences, 2022; 23(19): 11892.
9. ELLINGJORD-DALE M, et al. Long-term weight change and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. International Journal of Epidemiology, 2021; 32.
10. FORNILI M, et al. Association between menopausal hormone therapy, mammographic density and breast cancer risk: results from the E3N cohort study. Breast Cancer Research, 2021; 23(1).
11. GARG N, et al. Hormone Replacement Therapy Prescription after Premature Surgical Menopause. Journal of Minimally Invasive Gynecology, 2020; 27(7): 1618–1623.
12. GERTIG DM, et al. Hormone therapy and breast cancer: what factors modify the association?. Menopause, 2006; 13(2): 178–184.
13. GRACIA CR e FREEMAN EW. Onset of the Menopause Transition: The Earliest Signs and Symptoms. Obstetrics and Gynecology Clinics of North America, 2018; 45(4): 585–597.
14. GRAM MA, et al. Associations of body fat mass and fat-free mass with breast cancer incidence in postmenopausal women: A Danish prospective cohort study. Annals of Epidemiology, 2023.
15. HARPER-HARRISON G e SHANAHAN MM. Hormone Replacement Therapy. StatPearls Publishing, 2023.
16. JIANG Y, et al. Breast cancer incidence and mortality in relation to hormone replacement therapy use among postmenopausal women: results from a prospective cohort study. Clinical Breast Cancer, 2021.
17. LAMBRINOUDAKI I, et al. Menopause, wellbeing and health: A care pathway from the European Menopause and Andropause Society. Maturitas, 2022; 163: 1–14.
18. MARTINS SC, et al. Hormone Therapy and Breast Cancer: a literature review about the influence of hormonal treatment on neoplastic development. REVISTA MÉDICA DE MINAS GERAIS, 2021; 31.
19. MEHTA J, et al. Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts. Frontiers in Endocrinology, 2021; 12.
20. MINKIN MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstetrics and Gynecology Clinics of North America, 2019; 46(3): 501–514.
21. PALACIOS S, et al. Hormone therapy for first-line management of menopausal symptoms: Practical recommendations. Women’s Health, 2019; 15.
22. PAN M, et al. Update on hormone therapy for the management of postmenopausal women. BioScience Trends, 2022; 16(1): 46–57.
23. PRENTICE RL, et al. Randomized Trial Evaluation of the Benefits and Risks of Menopausal Hormone Therapy Among Women 50-59 Years of Age. American Journal of Epidemiology, 2021; 190(3): 365–375.
24. RANGER TA, et al. Hormone replacement therapy and cancer survival: a longitudinal cohort study: protocol paper. BMJ Open, 2021; 11(8): 046701.
25. SALAGAME U, et al. Menopausal Hormone Therapy use and breast cancer risk by receptor subtypes: Results from the New South Wales Cancer Lifestyle and EvaluAtion of Risk (CLEAR) study. PLOS ONE, 2018; 13(11): 02050347.
26. SANDVEI MS, et al. Menopausal hormone therapy and breast cancer risk: effect modification by body mass through life. European Journal of Epidemiology, 2018; 34(3): 267–278.
27. SANTORO N, et al. The Menopause Transition: Signs, Symptoms, and Management Options. The Journal of Clinical Endocrinology & Metabolism, 2020; 106(1): 1–15.
28. SCIOMER S e MOSCUCCI F. Menopausal hormone therapy and breast cancer risk: the cardiological point of view. Journal of Cardiovascular Medicine, 2020; 21(8): 538–539.
29. SHIFREN JL e GASS MLS. The North American Menopause Society Recommendations for Clinical Care of Midlife Women. Menopause, 2014; 21(10): 1038–1062.
30. TAVARES DSM, et al. Revisão integrativa: o que é e como fazer Integrative review: what is it? How to do it? Einstein, 2010; 8(1): 102–108.
31. THE WOMEN’S HEALTH INITIATIVE STUDY GROUP. Design of the Women’s Health Initiative Clinical Trial and Observational Study. Controlled Clinical Trials, 1988; 19(1): 61–109.
32. TK Y, et al. Hormone Replacement Therapy, Breast Cancer Risk Factors, and Breast Cancer Risk: A Nationwide Population-Based Cohort. Cancer Epidemiol Biomarkers Prev. 2020; 29(7): 1341-1347.
33. VAN DEN BRANDT PA, et al. Body size and weight change over adulthood and risk of breast cancer by menopausal and hormone receptor status: a pooled analysis of 20 prospective cohort studies. European Journal of Epidemiology, 2022; 36(1): 37–55.
34. WANG SM, et al. Use of postmenopausal hormone therapies and risk of histology- and hormone receptor-defined breast cancer: results from a 15-year prospective analysis of NIH-AARP cohort. Breast Cancer Research, 2020; 22(1).
35. WANG X, et al. Genome-wide interaction analysis of menopausal hormone therapy use and breast cancer risk among 62,370 women. Scientific Reports, 2022; 12(1).
36. WRITING GROUP FOR THE WOMEN'S HEALTH INITIATIVE INVESTIGATORS. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA: The Journal of the American Medical Association, 2002; 288(3): 321–333.
37. YEO SK e GUAN JL. Breast Cancer: Multiple Subtypes within a Tumor? Trends in Cancer, 2017; 3(11): 753–760.