Largest
Analysis To Date Indicates that Hormone Replacement Therapy
Increases Death Rates from Breast Cancer
According to recent results published in The Lancet, the largest
analysis to date has indicated that hormone replacement therapy
(HRT) not only increases the risk of developing breast cancer,
but increases the risk of death from breast cancer in postmenopausal
women.
Hormone replacement therapy (HRT) is often prescribed for
women during menopause. Menopause is a natural phase of maturing
womanhood, during which the ovaries produce significantly
less estrogen, ovulation ceases and menstruation ends. For
many women, menopause has uncomfortable side effects. Hot
flashes, sleep disturbances, depression, mood swings and anxiety
may affect the menopausal woman. Additionally, menopause may
also be accompanied by increased urinary tract infections,
incontinence, vaginal discomfort due to a lack of estrogen-based
lubrication and decreased bone density. HRT has been effectively
used to mitigate these side effects and is widely prescribed
for women experiencing these unpleasant symptoms of menopause.
Recent results from several clinical studies have demonstrated
a correlation between the use of hormone therapy and the development
of breast cancer. However, until now there has been no confirmatory
evidence supporting an increased risk of death from breast
cancer with the use HRT. HRT can contain estrogen alone, progesterone
alone or a combination of the two hormones. Research continues
in order to answers questions regarding different outcomes
for patients who use specific combinations or single-agent
HRT as well as duration of use.
Researchers from England recently evaluated data from over
one million women between the ages of 50 and 64 years in an
attempt to provide further information regarding HRT and breast
cancer incidence as well as mortality from breast cancer.
Results from this study indicated that women who used HRT
with estrogen alone had a 32% increased incidence of breast
cancer and those who used estrogen plus progestin HRT had
a 65% increased incidence of breast cancer. The incidence
of breast cancer increased with increased duration of use
of HRT. Furthermore, patients currently being treated with
HRT had an 22% increased mortality from breast cancer, compared
to those who had never used HRT or had used HRT in the past.
Patients using HRT for 5 and 10 years also have increased
incidence of uterine cancer, by an increase of 4 cases per
1,000 with 5 years of use and 10 per 1,000 with 10 years of
use.
The researchers concluded that HRT use not only increases
the risk of developing breast or uterine cancer, but also
increases the risk of mortality from breast cancer in postmenopausal
women. However, a duration of HRT use of 6 months of less
does not appear to increase risks of breast cancer. It remains
important that women discuss the risks and benefits of HRT
with their physician for their individual situation.
Reference: Million Women Collaborators. Breast Cancer and
Hormonal-Replacement Therapy in the Million Women Study. The
Lancet. 2003;362:419-427.
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