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HRT in breast cancer patients
Title: Estrogen replacement therapy in women with previous breast
cancer
Author: P. Natrajan, et al.
Address: Augusta, GA
Source: American Journal of Obstetrics and Gynecology 181: 288-295
(August) 1999
Summary: This retrospective study reviewing the status of patients with
breast cancer divided
patients into 3 groups: 50 using estrogen replacement, 8 using nonestrogenic
hormone replacement, and 18
using no hormones. In addition to estrogen use, 40 of the 50 hormone users were
treated with androgens,
and 45 subjects were also given progestogens. The 8 nonestrogen hormone users
were treated with various
combinations of testosterone pellets, tamoxifen, and progestogens. Of the 50
estrogen users, 3 have died
(mortality rate of 6%), and the rest have been followed for a mean duration of
83.3 + 8.81 months. One of
the 8 nonestrogen hormone users has died (mortality rate of 12.5%), and the rest
have been followed for a
mean duration of 72.0 + 5.93 months. Six of the 18 women not using hormone
replacement have died
(mortality rate of 33.3%), and the remainder followed for a mean duration of 50.5
+ 6.01 months. Estrogen
replacement therapy apparently does not increase either recurrences or mortality
rates. Adding
progestogens may even decrease recurrences. Women with early breast cancer should
be offered hormone
replacement therapy after a full explanation of the benefits, risks, and
controversies.
Comment: I wish I knew the answer. This is still controversial and
certainly all do not agree. The trend is
increasingly toward offering HRT.
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