LEADER 07318nam 2200709Ia 450 001 9910953845903321 005 20251017110114.0 010 $a9786610203604 010 $a9781280203602 010 $a1280203609 010 $a9780309597630 010 $a0309597633 010 $a9780585149011 010 $a0585149011 035 $a(CKB)111004366660606 035 $a(OCoLC)43477116 035 $a(CaPaEBR)ebrary10056851 035 $a(SSID)ssj0000215893 035 $a(PQKBManifestationID)11216875 035 $a(PQKBTitleCode)TC0000215893 035 $a(PQKBWorkID)10194722 035 $a(PQKB)10886702 035 $a(MiAaPQ)EBC3376577 035 $a(Au-PeEL)EBL3376577 035 $a(CaPaEBR)ebr10056851 035 $a(CaONFJC)MIL20360 035 $a(OCoLC)49853767 035 $a(Perlego)4739446 035 $a(DNLM)697227 035 $a(BIP)1171411 035 $a(EXLCZ)99111004366660606 100 $a19910513d1991 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt 182 $cc 183 $acr 200 10$aOral contraceptives & breast cancer /$fCommittee on the Relationship Between Oral Contraceptives and Breast Cancer, Institute of Medicine, Division of Health Promotion and Disease Prevention 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1991 215 $a1 online resource (195 p.) 300 $aBibliographic Level Mode of Issuance: Monograph 311 08$a9780309044936 311 08$a0309044936 320 $aIncludes bibliographical references and index. 327 $aOral Contraceptives & -- Breast Cancer -- Copyright -- Preface -- Contents -- Executive Summary -- MAINTAINING SURVEILLANCE -- DEVELOPING A BROADER ARRAY OF CONTRACEPTIVES -- ASSESSING KNOWLEDGE FOR APPLICATION IN CLINICAL PRACTICE -- FILLING GAPS IN BIOLOGICAL AND EPIDEMIOLOGICAL KNOWLEDGE -- 1 Introduction and Overview -- BIOLOGICAL PLAUSIBILITY OF A LINK BETWEEN ORAL CONTRACEPTIVES AND BREAST CANCER -- WHAT IS-AND IS NOT-KNOWN -- SEEKING ANSWERS -- 2 Epidemiology: Information Needs and Data Gaps -- EPIDEMIOLOGICAL RESEARCH -- Case-Control Method -- Cohort Studies -- Comparison Groups -- Ecological Studies -- Special Studies -- Women Exposed to Hormones Other than Oral Contraceptives -- Women Genetically Susceptible to Breast Cancer -- Estrogen Metabolism -- Progestins -- Changing Oral Contraceptive Formulations -- SUMMARY AND CONCLUSIONS -- 3 Biology: Information Needs and Data Gaps -- SIGNAL COMPLEXITY IN BREAST REGULATION -- RESEARCH ISSUES -- Relationships Among Cell Types -- Receptors -- Timing -- Effects of Pregnancy and Lactation -- Pathological Breast Tissue -- Oncogenes -- Molecular Changes Associated with Human Breast Cancer -- Activated ras Mutations -- Overexpression of Tyrosine Kinases -- Amplification of int-2 and myc -- Deletions of Genes -- RESEARCH MODELS -- Breast Cancer Cell Lines -- Short-term Culture of Normal Mammary Epithelium -- Organ Culture -- Nude Mouse Model -- SUMMARY AND CONCLUSIONS -- 4 Information for Users of the Pill and Health Care Providers -- BENEFITS AND RISKS OF ORAL CONTRACEPTIVES -- Benefits -- Risks -- CURRENT CONTROVERSY -- PRESCRIBING PROBLEMS -- 5 Policy Issues and Recommendations -- MAINTAINING SURVEILLANCE -- Cooperative Research -- Surveillance Requirements of the Food and Drug Administration -- DEVELOPING A BROADER ARRAY OF CONTRACEPTIVES. 327 $aASSESSING KNOWLEDGE FOR APPLICATION IN CLINICAL PRACTICE -- FILLING GAPS IN BIOLOGICAL AND EPIDEMIOLOGICAL KNOWLEDGE -- References -- Appendixes -- A Oral Contraceptives and Breast Cancer: A Review of the Epidemiological Evidence with an Emphasis ... -- Changing Profile Of Oral Contraceptive Use -- Biological Plausibility -- Epidemiological Studies Of Breast Cancer and Oral Contraceptives -- Ever" Use of Oral Contraceptives -- Duration of Oral Contraceptive Use -- Oral Contraceptive Use Before First Full-term Pregnancy or Before Age 25 -- Duration Since First Use of Oral Contraceptives (Latency) -- Use of Oral Contraceptives in High-Risk Subgroups -- Steroidal Potency of Various Formulations -- Issues to Consider in Reviewing the Epidemiological Evidence -- Discussion -- The Future -- References -- B Oral Contraceptives and Breast Cancer: Review of the Epidemiological Literature -- Methods -- Results -- Risk of Oral Contraceptive Users of All Ages in Developed Countries -- Risk in Oral Contraceptive Users in Developing Countries -- Risk in Oral Contraceptive Users With and Without Various Risk Factors for Breast Cancer -- Risk in Relation to Early Use of Oral Contraceptives -- Screening Bias -- Risk in Relation to Use of Oral Contraceptives Near the Age of Menopause -- Individual Formulations and Constituents of Oral Contraceptives -- Conclusions, Interpretations, and Recommendations for Further Research -- Acknowledgments -- References -- C The Evolving Formulations of Oral Contraceptives -- Implications for Research -- References -- D Animal Models of Sex Steroid Hormones and Mammary Cancer: Lessons for Understanding Studies in Humans -- Direct Tests of Carcinogenicity -- Mice and Rats -- Beagle Dogs -- Pharmacokinetics of Various Steroids in Mice, Rats, and Beagles. 327 $aStudies of Mechanisms for Mammary Carcinogenicity of Sex Steroid Hormones in Mice, Rats, and Dogs -- Conclusions -- Interesting Questions Raised by Animal Studies -- References -- E Risks and Benefits of Oral Contraceptives: Will Breast Cancer Tip the Balance? -- Established Benefits and Risks -- Balance of Benefits and Risks -- Oral Contraceptives and Breast Cancer -- An Effect in Young Women -- Conclusions -- References -- F List of Background Documents -- Index. 330 $aAt least 10.7 million American women use oral contraceptives (OCs). The potential connection with breast cancer has caused concern among these OC users and uncertainty among many of their physicians. This new volume offers the most up-to-date information available on this critical topic. While the best available knowledge does not support any fundamental change in clinical practice with respect to the use of OCs, this book offers specific recommendations for more research to fully resolve the relationship between OCs and breast cancer. Noting consumer confusion, the volume includes a concise summary of benefits, risks, and other practical information for contraceptive users and their doctors. The volume presents current data on changes in patterns of OC use, differences in risk at different ages, the benefits of OCs, and more. Oral Contraceptives and Breast Cancer will be important reading for obstetricians/gynecologists and other health professionals, their patients who use OCs, contraceptive manufacturers, women's health advocates, policymakers, and researchers. 517 1 $aOral contraceptives and breast cancer 606 $aBreast$xCancer$xEpidemiology$vCongresses 606 $aOral contraceptives$xSide effects$vCongresses 615 0$aBreast$xCancer$xEpidemiology 615 0$aOral contraceptives$xSide effects 676 $a616.99/449071 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910953845903321 996 $aOral contraceptives & breast cancer$94364042 997 $aUNINA