Oestrogen and Breast Cancer
More from the Women’s Health Initiative
Oestrogen-alone hormone therapy, used in women who have had a hysterectomy, does not increase breast cancer risk if used for seven years or less, as revealed recently from the Women’s Health Initiative.
Experts from the Women’s Health Secrets explain the latest study results from both the Women’s Health Initiative and the Nurses Health Study on the use of oestrogen-alone therapy in relation to breast cancer.
Note: Hormone therapy (HT) may also be referred to as hormone replacement therapy (HRT).
This robust randomised controlled data from the Women’s Health Initiative is now supported by new data from the large observational Nurses Health study showing that there is no increased risk of breast cancer in women taking oestrogen-alone for less than 10 years. This observational study reported in the Archives of Internal Medicine, suggests a small increased risk among women taking oestrogen for more than 20 years.
The use of oestrogen-alone in perimenopausal and menopausal symptomatic women who have had a hysterectomy does not increase breast cancer risk if used for seven to ten years. It is important for each woman to regularly discuss her individual risks and benefits of hormone therapy with her health practitioner.
The Women’s Health Initiative (WHI) was a large study with two arms focusing on hormone therapy (HT). It began in the US in 1997 and looked at the long-term use of oral hormone therapy in women aged 50-79 years for the prevention of heart disease. The combined oral oestrogen plus progestin therapy arm of the study was stopped in 2002 after women had been monitored for five years. It stopped when researchers found a slightly greater rate of breast cancer in the women taking oestrogen-progestin HT, although the increase was seen only in women who had been prior users of hormone therapy before starting in the study.
In 2004, the oestrogen-only arm of the WHI was stopped after seven years – a year ahead of schedule – because a beneficial effect of hormone therapy on heart disease risk was not found. They did, however, reveal a small increase in the incidence of strokes, primarily in those participants who were over 60 years of age at commencement. Researchers also found no increase in breast cancer risk. The latest results confirm these findings and offer some good news for women taking oestrogen-only HT.
The Nurses Health Study is a large, observational follow-up study of female nurses who have been followed since 1976. By the end of enrolment 28,835 menopausal women who’d had a hysterectomy were included. Women were asked every two years by questionnaire if they used hormones and whether they had developed breast cancer. Whilst this is a large trial, it is observational and the results need to be interpreted with caution and supported by randomised controlled trials, like the Women’s Health Initiative mentioned above.
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