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[Hormonal replacement therapy and breast cancer]
G Noël1, L Feuvret, M Gasowski
1Service d'oncologie-radiothérapie, Groupe hospitalier Pitié-Salpêtrière (AP-HP), 47-83, boulevard de l'hôpital, 75651 Paris Cedex 13.
Bulletin Du Cancer
|January 26, 1999
Summary
Hormonal replacement therapy increases breast cancer incidence, particularly with longer use. Risk returns to baseline after stopping treatment, and combined therapies may not be protective.
Area of Science:
- Endocrinology
- Oncology
- Epidemiology
Context:
- Hormonal replacement therapy (HRT) is widely used for menopausal symptom management.
- Conflicting evidence exists regarding HRT's impact on breast cancer risk.
- This review synthesizes data from 1980-1997 to clarify HRT's breast cancer implications.
Purpose:
- To evaluate the relationship between hormonal replacement therapy characteristics and breast cancer risk.
- To analyze how treatment duration, dosage, and type influence breast cancer incidence.
- To identify synergistic risk factors for breast cancer in HRT users.
Summary:
- HRT increases breast cancer incidence, with risk escalating with treatment duration.
- Low-dose estrogen (<0.625 mg/day) may suffice for menopausal relief.
- Breast cancer risk normalizes after HRT cessation; combined estrogen-progestin may not be protective.
Impact:
- HRT appears synergistic with late menopause and late first childbirth, increasing breast cancer risk.
- Specific populations (e.g., benign breast disease, family history) may not experience elevated risk.
- While HRT may lead to earlier breast cancer diagnosis via frequent mammography, overall survival remains unaffected.