Monday, January 31, 2011

More data on Hormone Replacement Therapy

Hormone replacement therapy (HRT) has been controversial in recent years. First thought to be helpful to avoid symptoms of menopause and to reduce the development of cardiac disease in post-menopausal women, clinical trials were halted in 2002 because of significant increases to the development of breast cancer and to no apparent benefit to reducing cardiac disease. While estrogen treatment alone, compared with estrogen + progesterone combinations, is better (reduced risk for developing breast cancer and lowers risk of cardiovascular disease and stroke), further studies have tried to determine if timing of administration offered any effect. Turns out that it does, although it’s not necessarily glowing news. Researchers in Britain just published findings in the Journal of the National Cancer Institute (2011, volume 103:296-305) indicating that taking HRT at the time or shortly after onset of menopause significantly increases the risk of developing breast cancer compared with those who took a greater than 5 year break before starting HRT therapy. Data in this paper also validates previous studies by the Women’s Health Initiative. Both groups have now shown that the risk of developing breast cancer increased coordinately with an increase in body mass index, however the risk associated with HRT did not further increase with BMI and therefore obesity does not influence the elevated risk associated with HRT. Additionally, although risk of breast cancer increases with prolonged HRT exposure, these risk levels decrease back to levels of those who have never taken HRT within 2- 3 years.

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