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Menopause Treatment News:
Making The HRT Decision - Continued
HRT and Breast Cancer Risks:
What You Should Know
While the impact of HRT on the heart may seem less ominous today than in 2002, links to breast cancer are less clear – and some say less encouraging.
Indeed, many experts believe that more than coincidence was at work when, in the years following the WHI announcement women stopped taking hormones en masse – and the incidence of breast cancer subsequently declined.
"A drop in hormone use may not have been the sole reason we saw fewer breast cancers, but I am certainly convinced it played a significant role," says Julia Smith, MD, director of the Lynne Cohen Breast Cancer Preventive Care Program at the NYU Medical Center in New York City.
But Smith says the back-story linking hormone use and breast cancer goes far beyond just connecting a few incriminating dots. It's a complex relationship, she says, that is still not fully explained – or explainable.
"What we have learned since the WHI is that for most women taking hormones short term – for 2 or 3 years for symptom relief – there won't be an increase in breast cancer in the short term, but this doesn't necessarily mean these women won't see an increase in breast cancer in the long term," says Smith.
Stuenkel tells WebMD even Mother Nature validates this line of thinking.
"Population studies for a women who go into menopause at age 55 instead of 50 , there is an overall increased risk of breast cancer – so the duration of hormone stimulation definitely matters," says Stuenkel. Indeed, the WHI revealed breast cancer risks clearly increased the longer a woman remained on HRT.
At the same time, however, Goldstein notes that at least one re-analysis of the WHI findings published in JAMA in 2006 found that women who had a hysterectomy and used estrogen-only therapy for an average of 7 years, had no increase in breast cancer rates.
"In fact, risks of at least one type of breast cancer were reduced in these women," says Goldstein.
But again, Stuenkel reminds us that the duration of hormone use might change that picture too. She points to results from the Harvard Nurses Study published in the Archives of Internal Medicine in 2006 which reported that those women who took estrogen only experienced an increase in breast cancer after 20 years of use.
"I have not bought into the idea that estrogen alone reduces breast cancer and for me the duration of exposure is still a key issue – when it comes to HRT, I just don't believe there's going to be a free lunch for any woman," says Stuenkel
NEXT UP: HRT : Making The Treatment Decision: What To Discuss With Your Doctor
"What we have learned since the WHI is that for most women taking hormones short term won't increase the risk of breast cancer -short term - but this doesn't necessarily mean these women won't see an increase in breast cancer in the long term."
Julia Smith,MD
YourMenopause.com
The Source
HRT And Breast Cancer Risks:What You Should Know
