Women's Health Medicine
Volume 3, Issue 1 , Pages 15-17, January 2006

HRT and breast cancer

Anna Glasier OBE FRCOG FFFP is Honorary Professor in the School of Clinical Sciences and Community Health at the University of Edinburgh and in the Department of Public Health Policy at the University of London School of Hygiene and Tropical Medicine, and Director of Family Planning and Well Woman Services for NHS Lothian.

Article Outline

Abstract 

Research on hormone replacement therapy (HRT) in the 21st century has been dominated by the findings of the Women’s Health Initiative (WHI) and Million Women Study (MWS). Clinical practice has changed accordingly. Both studies confirm an increase in the risk of breast cancer among women using combined HRT (oestrogen and progestogen) when compared with women who have never used HRT. The risk among women using oestrogen-only preparations of HRT, according to the MWS, is increased, but to a lesser extent than for women using combined HRT. In contrast the WHI Study suggests that oestrogen alone is not associated with an increased risk of breast cancer. Despite these different findings most evidence-based guidelines from professional organizations still advise use of HRT only for the relief of menopausal symptoms and only short term. Routine use of unopposed oestrogen for women with a uterus is being discussed but is still not recommended. New data have also led to the recommendation that HRT is contraindicated for women who have had breast cancer. More research is needed on the contribution of progestogens to the increased risk of breast cancer and on the safety of different routes of administration of both oestrogen and progestogen.

Keywords:  breast disorders , breast cancer , HRT , oestrogen , progestogen

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REFERENCES 

  1. Anderson GL , Limacher M , Assaf AR . Effects of conjugated equine estrogen in postmenopausal women with hysterectomy . JAMA . 2004;291:1701–1712
  2. Rossouw JE , Anderson GL , Prentice RL . Risks and benefits of estrogen plus progestin in health postmenopausal women: principal results . JAMA . 2002;288:321–333
  3. Hulley SB , Grady D . The WHI estrogen-alone trial – do things look any better? . JAMA . 2004;291:1769–1771
  4. Beral V . Breast cancer and hormone-replacement therapy in the Million Women Study . Lancet . 2003;362:419–427
  5. Olsson  , et al.   Hormone replacement therapy containing progestins and given continously increases breast carcinoma risk in Sweden . Cancer . 2003;97:1387–1392
  6. Banks E , Reeves G , Beral V . Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study . BMJ . 2004;329:477–479
  7. Levgur M . Hormone therapy for women after breast cancer . J Reprod Med . 2004;49:510–526
  8. Homburg L , Anderson H . HABITS (hormonal replacement therapy after breast cancer – is it safe?), a randomised comparison: trial stopped . Lancet . 2004;363:453–455
  9. Medicines and Healthcare Products Regulatory Agency and Committee on Safety of Medicines . Review of the evidence on long-term safety of HRT . Pharmacovigilance . 2004;30:4–7
  10. Haskell SG . Postmenopausal women’s experiences with discontinuing oestrogen replacement therapy . J Women’s Health . 2004;13:438–442
  11. Haas JS , Kaplin KP , Gerstenberger EP , Kerlikowske K . Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results . Ann Intern Med . 2004;140:184–189
  12. Welton A , Hepworth J , Collins N . Decision making about hormone replacement therapy by women in England and Scotland . Climacteric . 2004;7:41–49
  13. Hemminki E . Opposition to unpopular research results: Finnish professional reactions to the WHI findings . Health Policy . 2004;69:283–291

PII: S1744-1870(06)00118-1

doi:10.1383/wohm.2006.3.1.15

Women's Health Medicine
Volume 3, Issue 1 , Pages 15-17, January 2006

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