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Page 2
The Women's Health Initiative also involved a second study that was smaller in scope. Ten thousand women who had undergone hysterectomies were divided into two groups, and received either estrogen alone or placebo. Since they no longer had an intact uterus, endometrial cancer was no longer an issue. Progestin appears to further stimulate the growth of breast tissue, and may be a factor in increased risk for breast cancer. Preliminary evidence suggests that the estrogen-only treatment may be safer, but the study will continue for the planned 8.5 years.
There was also evidence that the cancers in the combined hormone treatment were more invasive. Diagnoses indicated 199 cases in the hormone treatment group versus 150 cases in the placebo group were invasive. The tumors in the hormone treatment group were larger at diagnosis, 1.7 centimeters on average versus 1.5 centimeters in the placebo group. The tumors had begun to spread in 25.4% of the hormone treatment group compared to 16 % in the placebo group. The percentage of women with abnormal mammograms was higher in the hormone treatment group, 9.4% versus 5.4% for the placebo group. Even after one year on the study, the percentage of women with abnormal mammograms was higher in the hormone treatment group, 8.8% versus 5.9%. This suggests an early onset of breast cancer for the hormone treatment group. Surprisingly, the results indicated that HRT was detrimental for development of cardiovascular disease, including stroke and pulmonary embolism. On the plus side, HRT showed to be of some benefit in reducing fractures due to osteoporosis, and to reduce colon cancer. However, these benefits were not of a great enough magnitude to offset the detrimental effects. Therefore, the study was terminated after about 5.5 years, three years earlier than planned. The authors of the study report concluded that HRT should not be used for the primary prevention of cardiovascular disease or osteoporosis, and that alternative treatments should be sought. HRT should only be used for short-term relief of vasomotor symptoms. The current recommendation of the American College of Obstetricians and Gynecologists closely follow those conclusions. References 1. Chlebowski, R. et. al. Influence of Estrogen Plus Progestin on Breast Cancer and Mammography in Healthy Postmenopausal Women. J Am Med Assn Vol. 289, No. 24 pp.3243-3253 (June 25, 2003)
The copyright of the article Hormone Replacement Therapy and Breast Cancer - Page 2 in Cancer Treatment is owned by . Permission to republish Hormone Replacement Therapy and Breast Cancer - Page 2 in print or online must be granted by the author in writing.
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