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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review covers the epidemiology of benign and neoplastic breast disease, the theoretical effects of steroids on the breast, and the effects of oral contraceptives on both. Breast cancer has been increasing since the 1940s in older U.S. women, killing about 44,500 of the 175,000 new cases per year. In addition fibrocystic breast disease may affect up to 50% of premenopausal women, resulting in 500,000 biopsies, of which 10% are cancerous, 33% of those in post-menopausal women. The involvement of steroids in development of the human breast, and in breast cancer, is reviewed. The breast does not complete its development until the end of the 1st pregnancy. The terminal ductal cells, from which breast cancers form, are susceptible to stimulation by progestins in nulliparas. Progestins, at least in the high doses used in early orals, protect against benign breast disease. Inadequate amounts of progesterone, however, as in irregular cycles, seem to predispose to breast cancer. Epidemiologic studies of oral contraceptive use and breast cancer are reviewed under the studies of oral contraceptive use and breast cancer are reviewed under the headings of overall results, age, age 45, parity, use before 1st pregnancy, use at young ages, latent effect, hormone formulation, associated benign breast disease, association with other neoplasms, and receptor status. There are slightly increased risks for cancer before age 45 for long-term use of pills before the 1st term pregnancy, although the data are not wholly consistent, in that the specific sub-groups of women affected differ in different studies. There is no clear evidence for a latent effect, that is, appearance of cancer 20-30 years after stopping the pill. Nor is there evidence of breast cancer linked to any specific pill type, nor with benign breast disease, nor with endometrial cancer. The reason for rising breast cancer rates is still unknown. The absolute number of increased cases related to oral contraceptives is insufficient to affect national rates. It is possible that the inconsistent findings in epidemiological studies reflects use of high-dose pills in the 1960s and early 1970s. The contraceptive and non-contraceptive benefits of the pill are more important for women's health than the potential cases of breast cancer in young women who took them for prolonged durations.
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PMID:Oral contraceptives and breast disease. 193 11

Although estrogens are the principal hormone needed by postmenopausal women, there are many benefits of progestins. There is some increased risk of endometrial cancer from estrogen-replacement therapy; however, added progestin decreases this risk to less than that observed in untreated postmenopausal women. Climacteric women at the greatest risk of endometrial cancer can be identified by the progestin challenge test. There may also be some protection from breast cancer in progestin-treated postmenopausal women. Progestins are effective in managing the increased breast tenderness and aggravation of fibrocystic breast disease that may occur in some estrogen-treated postmenopausal women. Both estrogens and progestins are effective in retarding the progression of osteoporosis, but estrogen-progestin combination therapy may promote new bone formation. Long-acting injectable progestins are effective in relieving vasomotor symptoms. Finally, progestins also reduce the incidence of postmenopausal bleeding and the necessity of diagnostic curettage. The progestin should be continued for ten days each month as long as the patient experiences withdrawal bleeding. When withdrawal bleeding ceases, the progestin may be discontinued. However, the progestin challenge test should be repeated annually to ensure that the endometrium is not being stimulated by either exogenous therapy or increased endogenous estrogens.
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PMID:Clinical use of progestins in the menopausal patient: dosage and duration. 713 46

Cowden's disease, or multiple hamartoma syndrome, is a rare condition classified recently as a hereditary preneoplastic syndrome. Multiple orocutaneous hamartomas are associated with involvement of other organ systems, including fibrocystic breast disease and breast carcinoma, goiter, thyroid cancer, gastrointestinal polyps, and endometrial carcinoma. We describe a patient with Cowden's disease who underwent extensive gastroenterological work-up and review other cases in the literature.
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PMID:Cowden's disease with extensive gastrointestinal polyposis. 811 85

The article by Benjamin Sachs and several members of the Family Planning Evaluation Division at the Centers for Disease Control states forcefully that the efforts to improve the health of women in their reproductive years have been extraordinarily effective over the past 25 years and that total deaths among women who are either trying to prevent pregnancy or who are pregnant are dropping markedly. Some journalists appear to have gathered the wrong message from this article. Sachs and his colleagues have shown that there are risks from using contraceptives and that those risks are now almost as great, in terms of absolute numbers, as the risks of pregnancies to American women. That does not mean that oral contraceptives (OCs) are as dangerous as pregnancy. The article should have placed more emphasis on the fact that the excess attributable mortality rate from contraceptives is far lower than the mortality rate attributable to pregnancy. Many important points are made in this article, and the following are directed to family planners: 1) the effort should made to think in terms of "reproductive mortality" rather than simply in terms of maternal mortality, 2) over the next 6 months there will be many questions relating to the safety of providing OCs to teenagers without parental consent, 3) there is a need to recognize that the deaths caused by modern contraceptives center primarily in heavy smokers using OCs in the latter half of the their reproductive life span, and 4) there are women dying of contraceptive complications whose deaths might be prevented if closer attention was paid to the OC danger signals. The concept of reproductive mortality allows epidemiologists, clinicians, and women to put into perspective all the risks of sexual intercourse. Most would argue that the benefits of highly effective contraceptives have exceeded the risks. This is particularly the case if one includes the numerous noncontraceptive benefits of OCs such as prevention of pelvic inflammatory disease, anemia, ovarian and endometrial cancer, and fibrocystic breast disease.
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PMID:Family planners need to absorb importance of mortality study. 1227 29

Numerous non-contraceptive benefits of combined oral contraceptive (OC) use have been identified. The risk of endometrial cancer is reduced by 20% after 1 year of use, 50% after 4 years of use, and 71% after 12 years of use compared with the risk among non-users and this protective effect persists up to 15 years after OC discontinuation. There is a 30% overall reduction in ovarian cancer risk (50% after 5 years of OC use) and the protective effect lasts at least 10 years after ending pill use. For cervical cancer, OC use is associated with a slight increase in risk, although other causative factors may be implicated. The risk of follicular ovarian cysts is reduced by about 50%, while that of cysts from the corpus luteum declines by as much as 80%. Combined OCs also reduce the risk of fibrocystic breast disease and fibroadenomas by about 25%. Both low- and high-dose OCs reduce pelvic inflammatory disease by up to 50% and, if OC users do develop this infection, it is generally less severe than in non-users. Also recorded has been a 90% reduction in risk of ectopic pregnancy. Since OCs shorten the menstrual period and amount of blood loss, they protect against iron-deficiency anemia. Finally, OC users have a 60% reduced risk of dysmenorrhea.
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PMID:Non-contraceptive benefits of oral contraceptives. 1229

Progestins in oral contraceptives (OCs) produce potential complications, as well as noncontraceptive benefits, according to Robert A. Hatcher, MD, MPH, professor of gynecology and obstetrics, Emory University Medical School. Hatcher told CTU that lowering the progestin content in an OC may decrease complications, but could also decrease the benefits experienced by women. "The extent to which that will happen remains to be seen," he said. Hatcher cited the following potential complications of progestins in OC: hypertension; decreased levels of high density lipoproteins; acne; oily skin; headaches between pill cycles; dilated leg veins; pelvic congestion syndrome; thrombosis of superficial leg veins; gallstones; Monilia vaginitis; cholestatic jaundice; and depression, fatigue, and decreased libido. Progestins, according to Hatcher, also produce these noncontraceptive benefits: protection against PID; decreased dysmenorrhea; decreased menstrual blood loss, decreased iron deficiency anemia; protection against endometrial cancer; protection against fibrocystic breast disease, and fibroadenomas of the breast; decreased bleeding from fibroids; decreased growth of fibroids. When ovulation is suppressed, Hatcher emphasized, additional benefits that may occur include the following: decreased risk of functional ovarian cysts; elimination of mittleschmerz pain; decreased rick of ovarian cancer; protection against endometriosis.
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PMID:Potential risks, benefits of progestins in birth control pills outlined. 1231 83

The appearance of endometrial cancer in adolescence is uncommon and warrants investigation for an hereditary cancer syndrome. Cowden syndrome is an autosomal dominant cancer syndrome associated with a germline PTEN mutation and increased risk of breast, thyroid, endometrial and colon cancer. In this report we present a case of a 14-year-old nulligravid female diagnosed with grade 1 endometrial adenocarcinoma. She subsequently developed fibrocystic breast disease and colon polyps and was diagnosed with Cowden syndrome at age 20. We therefore recommend formal evaluation for Cowden syndrome to be considered when endometrial cancer is diagnosed in adolescence.
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PMID:Endometrial cancer in a 14-year-old girl with Cowden syndrome: a case report. 2327 35