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Hormone replacement therapy and breast cancer
1Reproductive Endocrinology, Royal Free and University College London Medical School, The Middlesex Hospital, Mortimer Street, London W1N 8AF, UK.
Endocrine-Related Cancer
|May 16, 2000
Summary
Long-term hormone replacement therapy (HRT) increases breast cancer risk, similar to delaying menopause. Use the lowest effective HRT dose, especially considering individual susceptibility and environmental factors like alcohol intake.
Area of Science:
- Oncology
- Endocrinology
- Epidemiology
Background:
- Concerns exist regarding hormone replacement therapy (HRT) and breast cancer risk.
- Epidemiological studies are complex due to small effect sizes and confounding factors.
Purpose of the Study:
- To review current research on HRT and breast cancer risk.
- To discuss individual susceptibility and environmental factors.
- To provide clinical implications for HRT use.
Main Methods:
- Review of epidemiological, endocrinological, and tumor cell biology research.
- Analysis of studies on individual susceptibility and environmental interactions (e.g., alcohol).
Main Results:
- Long-term HRT (>10 years) is associated with increased breast cancer risk, comparable to delaying menopause.
- Risk is linked to endogenous and exogenous estrogen levels.
- Subcutaneous estrogen implants can lead to high estrogen levels and should be used cautiously.
Conclusions:
- The lowest effective HRT dosage is recommended.
- HRT use should be carefully considered, especially concerning duration and administration route.
- Potential HRT strategies for women with a history of breast cancer are discussed, including low-dose estrogen with selective estrogen receptor modulators.