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Hormone-replacement therapy in patients with breast cancer. A reappraisal
1Dorothy Marsh Chair in Reproductive Biology, University of California, Irvine.
Background:
It has been common practice to prohibit hormone-replacement therapy (HRT) in patients with breast cancer. A reappraisal of this practice is necessary because hundreds of reports have established the benefits of HRT in coronary artery disease, osteoporosis, the serum lipid profile, and quality of life.
Methods:
An argument is presented to support the safety of HRT use in such patients in the absence of a prospective randomized study addressing these issues. This argument relies primarily on historical data.
Results:
There is no direct evidence that the use of HRT adversely affects patients who have previously been afflicted with breast cancer.
Conclusions:
A prospective randomized study is essential to resolve this issue. In the meantime, patients should be counseled regarding the theoretical adverse effects of HRT versus the proven beneficial effects and the final decision for its use rests with the patient.