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In Reply: Each of these letters expresses concern that the association of antibiotic use with increased risk of breast cancer may be confounded by patient characteristics. As we stated in our article, we agree with the need for a thorough exploration of confounding as a possible explanation of the findings. We made every effort to obtain information on pertinent characteristics and to examine the possibility of confounding with the available data. We also stated that information was incomplete on several patient characteristics and not available on other characteristics, and this may have limited our ability to detect and control confounding.

Dr Shear and colleagues and Dr Harpe raise a concern about the effect on the risk estimates of adjustment for patient characteristics beyond age and duration of insurance enrollment. As we stated, analyses that adjusted for other potential confounders (listed in Table 1 of our article) typically did not change . . . [Full Text of this Article]

Christine M. Velicer, PhD; Susan R. Heckbert, MD, PhD
heckbert@u.washington.edu

John D. Potter, MD, PhD; Stephen H. Taplin, MD, MPH

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