Health Care

HRT for menopause increases breast cancer risk

HRT for menopause increases breast cancer risk”

Hormone replacement therapy (HRT) raises the risk of getting breast cancer by a third - double previous estimates.

They concluded that Menopausal hormone therapy (MHT) was responsible for around one million breast cancers in western countries - one-twentieth of the total since 1990. "To put the risk into context, a woman has greater risk of developing breast cancer if she is overweight or obese compared to taking HRT". Researchers found those who are using MHT are at double the risk of being diagnosed with breast cancer than women who never use the medication. Current users still had an increased risk even during the first four years of therapy (estrogen-progestogen risk ratio (RR) 1.60, 95% confidence interval [CI] 1.52-1.69; estrogen-only RR 1.17; 95% CI 1.10-1.26), although the risk was substantially greater during years five through 14 (estrogen-progestogen RR 2.08, 95% CI 2.02-2.15; estrogen-only RR 1.33, 95% CI 1.28-1.37).

Hormone therapy keeps symptoms like hot flashes and dry vagina in check in menopausal women.

In North America and Europe, MHT increased rapidly during the 1990s, halved abruptly in the early 2000s, and then stabilised about ten years ago.

Regulators in Europe and the U.S. recommend HRT be used for the shortest time needed. Although some are short-term users, about five years of use is now common, whereas about 10 years of use used to be common.

More prolonged use carries an even higher risk, said co-author Gillian Reeves from the University of Oxford.

This excess risk was not only associated with duration of use, but was also dependent on the frequency of hormone use, the researchers noted.

They also found the length of time for which a woman used MHT, and the length of time since she stopped had a bearing on the risk factor as well.

And the danger remains for more than a decade after the menopause treatment, a major study shows. Among these women who developed the disease, half had used MHT.

This was for those who took the treatment for five years, starting at age 50. It was slightly lower for women taking estrogen plus intermittent progestogen - 7.7 per 100.

Now, a new study looks at whether there is a link between menopausal hormone therapy and the risk of developing breast cancer.

There was little excess risk after using any form of MHT for less than a year.

The new report, published August 29 in The Lancet, "again reinforces that known increased risk, but more importantly, it identifies that the risk persists even after the therapy is stopped, and is affected by the length of time that the patient takes hormone replacement", Cassell said.

He said: "We would urge patients not to panic as a result of this research, and to continue taking HRT as it has been prescribed to them -- and we would urge prescribers to do so as normal until clinical guidelines recommend otherwise".

Prof Stephen Evans, Professor of Pharmacoepidemiology, London School of Hygiene and Tropical Medicine (LSHTM), said: "These results should not be used to cause alarm among women, but there is no doubt that they should follow the advice given by the MHRA in the United Kingdom and the FDA in the U.S. that MHT be used for the shortest time that it is needed".

The researchers found that for women of average weight in Western countries, five years of using estrogen plus a daily progestogen hormone therapy, starting at age 50, was associated with an increased risk of breast cancer up to age 70.

"This is a "tour de force" in what has been done and the way it has been done - the findings can not be dismissed".

Dr. Alice Police directs breast surgery at Northwell Health Cancer Institute in Sleepy Hollow, N.Y. Looking over the study, she said that as time goes by, research like this is giving women better guidelines on what is or is not safe when it comes to hormonal therapies.

Hormone therapy is now used by millions of women to relieve common symptoms of menopause.



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