Hormone replacement therapy in postmenopausal women and risk of breast cancer

Research output: Contribution to journalArticle

Abstract

Long-term use of Hormone replacement therapy (HRT) in asymptomatic postmenopausal women has been reported to significantly reduce mortality from Coronary Heart Disease (CHD) and incidence of hip fracture in older women. An increased risk of endometrial cancer in women treated with unopposed oestrogen has been observed and a potential increased risk of breast cancer in women treated with oestrogen, alone or combined with progestins, has been hypothesised. Available studies show conflicting results. Low doses (≤ 0.625 mg/day) used for no longer than 5 years proved to be safe. Inconsistent results are available for higher dosages. A 20-40% increased risk was observed for long-term treatments (6-20 years or more). The addition of a progestational agent to oestrogen (EPRT) substantially decreased the risk of endometrial carcinoma, while the impact of the association on the risk of breast cancer has not been evaluated yet. No interaction between HRT and known risk factors for breast cancer have been observed. The opportunity of HRT for women previously treated for breast cancer who report severe postmenopausal symptoms and who are disease-free after the primary treatment and are at low risk of relapse on the basis of the available prognostic factors is under evaluation. The widespread use of HRT in postmenopausal women is a consequence of the observed decreased mortality from CHD in long-term treated women. However, it has to be taken into account that CHD is spontaneously decreasing in the western world and that the highest mortality rates for CHD or as a consequence of hip fracture has been expected in women after 75 years of age: the benefit from a 10 year treatment with HRT has been dramatically diminished at that age. Caution is necessary when oral HRT is proposed as a tool for primary prevention in postmenopausal women, particularly in countries at low risk for CHD.

Original languageEnglish
Pages (from-to)27-34
Number of pages8
JournalMedecine Biologie Environment
Volume26
Issue number1
Publication statusPublished - 1998

Keywords

  • Breast cancer
  • Epidemiology
  • Hormone
  • Menopause
  • Oestrogen
  • Progestin
  • Risk factors

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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