Menopausal Estrogen and Estrogen-Progestin Replacement Therapy and Breast Cancer Risk

Article Abstract:

Hormone replacement therapy using a combined estrogen-progestin regimen increases the risk of breast cancer more than the risk with estrogen alone. In a study of 46,355 postmenopausal women, the relative risk of breast cancer increased by 0.01 with each year of estrogen-only use and by 0.08 with each year of estrogen-progestin-only use. However, this increased risk only occurred in women who had used hormone therapy in the previous 4 years. It also only occurred in thin women, whereas heavier women had no increased risk regardless of which form of hormone therapy they used.

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Risk of breast cancer after estrogen and estrogen-progestin replacement

Article Abstract:

The risk of breast cancer after non-contraceptive treatment with estrogen was examined. There is convincing evidence that hormones produced in the body are involved in the development of breast cancer. The aim of the study was to analyze the risk of breast cancer after treatment with estrogens and combinations of estrogen and progestin in a large population-based cohort. The researchers noted a ten percent increase in the relative risk of breast cancer in women for whom estrogens were prescribed for symptoms of menopause. The risk increased with increasing duration of treatment. The type of estrogen used and the presence of progestin affected the risk of breast cancer. The addition of progestin offered no protection against the development of breast cancer, which raises the improtant concern about the long-term treatment with a combination of estrogens and progestins that has been proposed for widespread use as prophylaxis against osteoporosis in menopausal women.

Analysis, Complications and side effects, Drug therapy, Health risk assessment, Progestational hormones

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Postmenopausal hormone-replacement therapy - time for a reappraisal?

Article Abstract:

It may be necessary to re-evaluate the long-term use of estrogen replacement therapy. A 1997 study found that estrogen lowered the risk of death in a group of postmenopausal women. However, over the long-term, this benefit diminished due to a 43% increase in deaths from breast cancer in women who used estrogen for 10 years or more. Research is needed to determine whether the risk of breast cancer is heightened by the use of estrogen combined with progestins compared to estrogen alone. The risks of estrogen use may outweigh the benefits in women with a low risk of heart disease but a high risk of breast cancer.

Editorial, Patient outcomes, Mortality, Coronary heart disease

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