HRT breast cancer risk

Hormone replacement therapy significantly increases the risk of breast cancer, especially among women receiving a combination of estrogen and progestin, a British study has found.

The report, published in this week's edition of British medical journal The Lancet, concluded that women now receiving hormone replacement therapy (HRT) had a 22 per cent higher risk of breast cancer than women who were not receiving therapy.

However, a US medical specialist who was not involved in the British study said it did not settle the question of whether estrogen by itself posed a significantly higher risk of cancer.

The Lancet report was based on the "Million Woman Study", which surveyed 1,084,110 women in the United Kingdom, aged 50 to 64. They were recruited between 1996 and 2001, and tracked for cancer incidence and death.

Professor Valerie Beral, director of the Cancer Research UK Epidemiology Unit and lead author of the study, said there was "overwhelming evidence" that the combination therapy was associated with greater cancer risk.

Among 1,000 postmenopausal women who did not use hormone replacement therapy (HRT), there would be about 20 breast cancer cases among women between the ages of 50 and 60, Beral said.

In every 1,000 women who began 10 years of HRT at the age of 50, there would be five extra cases among estrogen-only users, and 19 among estrogen-progestin combination users, she said.

"The evidence is now compelling that estrogen plus progestin is more deleterious to the breast than estrogen alone," said JoAnn Manson of the Harvard University Medical School.

"However, there continues to be controversy about whether unopposed estrogen increases the risk of breast cancer," said Dr Manson, who was not involved in the British study.

Manson said the Women's Health Initiative, a United States government-sponsored study of 16,608 postmenopausal women aged 50 to 79, "will provide conclusive answers to this question in the next two years".

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The above information is provided for general educational purposes only. It is not intended to replace competent health care advice received from a knowledgeable healthcare professional. You are urged to seek healthcare advice for the treatment of any illness or disease.
Health Canada and the FDA (USA) have not evaluated these statements. This product is not intended to diagnose, treat, cure, or prevent any disease.