HORMONE REPLACEMENT: Dual Therapy Ups Breast Cancer Risk

     Post-menopausal women who take a commonly-prescribed combination of estrogen and progestin hormone therapy to alleviate symptoms associated with menopause may increase their risk of developing breast cancer by 20% compared to those who take estrogen only, according to a new study in today's Journal of the American Medical Association, the AP/Nando Times reports. Researchers at the National Cancer Institute and the University of Massachusetts analyzed data from mammograms collected from 46,355 women between 1980 and 1995 and found that 2,082 women developed breast cancer. Compared to those who never took hormone therapy, women who used estrogen-only therapy within the previous four years were at a 20% higher risk to develop breast cancer, while those using a combination of estrogen and progestin within that period were 40% more likely to develop the disease (Tanner, 1/26). In addition, the study found that for each year women take estrogen-only therapy, their risk of breast cancer increased by 1%; for those on combination therapy, the risk increased by 8% per year. Lead researcher Catherine Schairer of NCI said, "I think these results should not discourage a woman from using hormones on a short-term basis for treatment of menopausal symptoms. Long-term use is more questionable" (Okie, Washington Post, 1/26).

Not For Prolonged Use
      Estrogen is used by millions of women to offset the increased risks of osteoporosis and heart disease associated with menopause. In recent years, physicians have recommended the estrogen-progestin combination to reduce the increased risk of uterine cancer associated with estrogen-only therapy. However, the new findings indicate that prolonged use of hormone therapy "is a big ... risk, given that breast cancer is pretty common to begin with," according to Harvard epidemiologist Dr. Walter Willett (Roan, Los Angeles Times, 1/26). In an editorial accompanying the JAMA study, Willett and co-authors Graham, Colditz and Meir Stampfer indicate that women who need hormone replacement therapy for short-term relief of menopausal symptoms do not need to worry about increasing their risk of breast cancer (Rubin, USA Today, 1/26). However, Willett said in an interview, "This is complex, and there is no single answer for all women. Women need to discuss this with their physicians" (Los Angeles Times, 1/26).