Levonorgestrel-releasing intrauterine system and the risk of breast cancer: A nationwide cohort study

/

Tuuli Soini, Ritva Hurskainen, Seija Grénman, Johanna Mäenpää, Jorma Paavonen, Heikki Joensuu
Acta Oncologica Volume 55, 2016 - Issue 2 Pages 188-192 | Received 04 May 2015, Accepted 03 Jun 2015, Published online: 04 Aug 2015

“Background. Prolonged steroid hormone therapy increases the risk of breast cancer, especially the risk of lobular cancer, but the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) use is controversial. In this study we aimed to test the hypothesis that risk for lobular breast cancer is elevated among LNG-IUS users.”

“Conclusions. The results imply that intrauterine administration of levonorgestrel is not only related to an excess risk of lobular breast cancer but also, in contrary to previous assumptions, to an excess risk of ductal breast cancer.”

References

  • Ferlay J, Soerjomataram II, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2014;136:E359–86.

  • Engholm G, Ferlay J, Christensen N, Kejs AMT, Johannesen TB, Khan S, et al. NORDCAN: Cancer incidence, mortality, prevalence and survival in the Nordic countries, version 7.0 (December 2014). Association of the Nordic Cancer Registries. Danish Cancer Society. [cited 2015 Mar 12]. Available from http://www.ancr.nu.

  • Stanczyk FZ, Hapgood JP, Winer S, Mishell DR, Jr. Progestogens used in postmenopausal hormone therapy: Differences in their pharmacological properties, intracellular actions, and clinical effects. Endocr Rev 2013;34:171–208. 

  • Lambrinoudaki I. Progestogens in postmenopausal hormone therapy and the risk of breast cancer. Maturitas 2014;77: 311–7. 

  • Fabre A, Fournier A, Mesrine S, Gompel A, Desreux J, Berrino F, et al. Progestagens use before menopause and breast cancer risk according to histology and hormone receptors. Cancer Epidemiol Biomarkers Prev 2008;17:2723–8. 

  • Gierisch JM, Coeytaux RR, Urrutia RP, Havrilesky LJ, Moorman PG, Lowery WJ, et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: A systematic review. Cancer Epidemiol Biomarkers Prev 2013;22:1931–43. 

  • Tavassoli FA, Devilee P, ed. World Health Organization classification of tumours. Pathology and genetics of tumours of the breast and female genital organs. Lyon: IARC Press; 2003. 

  • Dossus L, Benusiglio PR. Lobular breast cancer: Incidence and genetic and non-genetic risk factors. Breast Cancer Res 2015;17:37. 

  • Newcomer LM, Newcomb PA, Trentham-Dietz A, Longnecker MP, Greenberg ER. Oral contraceptive use and risk of breast cancer by histologic type. Int J Cancer 2003; 106:961–4. 

  • Luukkainen T, Lahteenmaki P, Toivonen J. Levonorgestrel-releasing intrauterine device. Ann Med 1990;22:85–90. 

  • Lyytinen HK, Dyba T, Ylikorkala O, Pukkala EI. A case-control study on hormone therapy as a risk factor for breast cancer in Finland: Intrauterine system carries a risk as well. Int J Cancer 2010;126:483–9. 

  • Backman T, Rauramo I, Jaakkola K, Inki P, Vaahtera K, Launonen A, et al. Use of the levonorgestrel-releasing intrauterine system and breast cancer. Obstet Gynecol 2005; 106:813–7. 

  • Dinger J, Bardenheuer K, Minh TD. Levonorgestrel- releasing and copper intrauterine devices and the risk of breast cancer. Contraception 2011;83:211–7. 

  • Soini T, Hurskainen R, Grénman S, Mäenpää J, Paavonen J, Pukkala E. Cancer risk in women using the levonorgestrel-releasing intrauterine system in Finland. Obstet Gynecol 2014;124:292–9. 

  • Gaudet MM, Gapstur SM, Sun J, Teras LR, Campbell PT, Patel AV. Oophorectomy and hysterectomy and cancer incidence in the Cancer Prevention Study-II Nutrition Cohort. Obstet Gynecol 2014;123:1247–55. 

  • Rothman KJ, Greenland S, Lash TL, eds. Modern epidemiology, 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008. 

  • Cerne JZ, Frkovic-Grazio S, Gersak K. Breast tumor characteristics in hormone replacement therapy users. Pathol Oncol Res 2011;17:917–23. 

  • Stahlberg C, Pedersen AT, Andersen ZJ, Keiding N, Hundrup YA, Obel EB, et al. Breast cancer with different prognostic characteristics developing in Danish women using hormone replacement therapy. Br J Cancer 2004;91: 644–50. 

  • Hidalgo MM, Hidalgo-Regina C, Bahamondes MV, Monteiro I, Petta CA, Bahamondes L. Serum levonorgestrel levels and endometrial thickness during extended use of the levonorgestrel-releasing intrauterine system. Contraception 2009;80:84–9. 

  • Mueck AO, Ruan X, Seeger H, Fehm T, Neubauer H. Genomic and non-genomic actions of progestogens in the breast. J Steroid Biochem Mol Biol 2014;142:62–7. 

  • Ravdin PM, Cronin KA, Howlader N, Berg CD, Chlebowski RT, Feuer EJ, et al. The decrease in breast- cancer incidence in 2003 in the United States. N Engl J Med 2007;356:1670–4. 

  • Suhrke P, Maehlen J, Zahl PH. Hormone therapy use and breast cancer incidence by histological subtypes in Sweden and Norway. Breast J 2012;18:549–56. 

  • Marmot MG, Altman DG, Cameron DA, Dewar JA, Thompson SG, Wilcox M. The benefits and harms of breast cancer screening: An independent review. Br J Cancer 2013;108:2205–40. 

  • Leminen H, Heliövaara-Peippo S, Halmesm ki K, Teperi J, Grénman S, Kivelä A, et al. The effect of hysterectomy or levonorgestrel-releasing intrauterine system on premenstrual symptoms in women treated for menorrhagia: Secondary analysis of a randomized controlled trial. Acta Obstet Gynecol Scand 2012;91:318–25.

  • Anderson WF, Rosenberg PS, Petito L, Katki HA, Ejlertsen B, Ewertz M, et al. Divergent estrogen receptor-positive and -negative breast cancer trends and etiologic heterogeneity in Denmark. Int J Cancer 2013;133:2201–6. 

  • Toriola AT, Colditz GA. Trends in breast cancer incidence and mortality in the United States: Implications for prevention. Breast Cancer Res Treat 2013;138:665–73.