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4 3) Beresford SAA, Weiss NS, Voigt LF, et al: Risk of endometrial cancer in relation to use of oestrogen combined with cyclic progestagen therapy in postmenopausal women. Lancet 349: , ) Daly E, Vessey MP, Hawkins MM, et al; Risk of venous thromboembolism in users of hor mone replacement therapy. Lancet 348: , ) Tavani A, Braga C, Vecchia CL, et al: Hor mone replacement treatment and breast cancer risk: an age-specific analysis. Cancer Epidem Biomar 6: 11-14, ) Collaborative Group on Hormonal Factors in Breast Cancer: Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of woman with breast cancer and women without breast cancer. Lancet 350: , ) Writing Group for the Women's Health Initia tive Investigators: Risks and benefits of estrogen plus progestin in healthy post menopausal women, principal results from the women's health initiative randomized controlled trial. JAMA 288: , ) Cheek J, Lacy J, Toth-Fejel S, et al: The impact of hormone replacement therapy on the detection and stage of breast cancer. Arch Surg 137: , ) Holli K, Isola J, Cuzick J: Low biologic aggres siveness in breast cancer in women using hor mone replacement thepapy. J Clin Oncol 16: , ) Sacchini V, Zurrida S, Andreoni G, et al: Path ologic and biological prognostic factors of

5 breast cancers in short-and long-term hormene replacement therapy users. Ann Surg Oncol 9: , ) Gapstur SM, Morrow M, Sellers TA: Hormone replacement therapy and risk of breast cancer with a favorable histology. JAMA 281: , 1999 A CASE OF MUCINOUS CARCINOMA OF THE BREAST AFTER A ONE-YEAR HORMONE REPLACEMENT THERAPY Takayasu ITO, Kazuhisa FUKUSHIMA, Shoji KUROKI*, Makoto KUBO*, Takahiro INOUE* and Masao TANAKA* Ito Clinic *Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University A 56-year-old woman, who had been receiving hormone replacement therapy (HRT) for post menopausal symptoms for one year, found a small mass in the D area of her right breast. The tumor 1. 5cm in diameter was diagnosed as mucinous carcinoma by mammography, ultrasonography, MRI, and aspiration cytology. Wide excision and sentinel lymph node biopsy were performed. As the result of sentinel lymph node biopsy was negative, axillary lymph node dissection was not done. Histologic examination revealed that the tumor was pure type of mucinous carcinoma and classified as stage I (pt1c, N0, M0), ER(+), PgR(+), Her2(-). Although HRT slightly increases the incidence of breast cancer, the HRT-related breast cancers have a relatively low malignant potential with less aggressive histological types of carcinomas and a favorable prognosis. As HRT is important to maintain health of postomenopausal women whose average span of post menopausal life has come to about 30 years, it will be more widely used in Japan. Thus, careful screening of breasts before and during HRT is highly recommended.

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