Bca Risk May Offset Benefits of HRT

Breast Cancer Risk May Offset Benefits Hormone Therapy "Postmenopausal hormone therapy: less favourable risk–benefit ratios in healthy Dutch women"

Increased risk of breast cancer offsets much of the benefit of long-term postmenopausal hormone therapy, even in women with a high-risk profile for cardiovascular disease, Dutch researchers suggest.

Investigators examined the effects of 10 and 20 years of postmenopausal hormone therapy on a synthetic cohort of 55-year old Dutch women. They used existing estimates of hormone therapy effects on myocardial infarction, hip fracture and breast cancer to calculate the long-term health effects on women at both average and high-risk for cardiovascular disease.

Results of the analysis showed that women who start 10 years of hormone therapy at age 55 could prolong their lives by one month and postpone the first incidence of myocardial infarction and hip fracture by 2.4 months. For every five to six cases of averted myocardial infarction or fracture, one extra case of breast cancer occurred.

When therapy was prolonged to 20 years, life was prolonged by two months and the delay before the first incidence of myocardial infarction or hip fracture was doubled. Risk of breast cancer also increased, with one extra case for every three to four averted cases of the other diseases.

Women who had a high risk of cardiovascular disease had twice the health gains from hormone therapy compared with women of average risk, but they also showed increased risk of breast cancer, especially with 20 years of treatment.

"Women at increased cardiovascular risk can benefit more from hormone therapy," the researchers conclude, "but even amongst these women, the risk of breast cancer incurred with long-term use offsets much of the benefit that could accrue from changing the risk of heart disease and hip fracture."

Thanks to James Adams at Doctors' Guide

HRT and Breast Ca Detection (Intervals)

Euro Breast Cancer conf 3/02

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