[Hormone replacement therapy after breast cancer]

The use of hormone replacement therapy after breast cancer is controversial. The published epidemiological studies shown no association between HRT and recurrence of breast cancer. However, the interpretation of these results is very difficult because of numerous biases in this context of observational studies. Prospective randomised trials that examine the effects of HRT in women with a history of breast cancer are currently underway in United States and in Scandinavia. The markov approach is interesting for determining the global risk-benefit balance of HRT and for visualising the effects of different risk levels on breast cancer and to compare different therapeutic strategies. Hot flushes and functional symptoms represent the essential unresolved problem of these women. The results of all these will provide valuable data to define efficient and non-deleterious approaches to improve the well being of the women after breast cancer.