Menopausal women should avoid hormone therapy, study finds
September 23, 2010
Joseph Hall and Megan Ogilvie
HEALTH REPORTERS
Only women with the most severe menopausal symptoms should even consider hormone replacement therapy, says the author of a new study showing a strong link between the treatment and breast cancer.
Incidents of breast cancer in Canada plunged 10 per cent in women of menopausal age after the use of the therapies dropped by half last decade, the Canadian Cancer Society study shows.
“The Canadian Cancer Society’s recommendation is that women should avoid using HRT for any reason other than to relieve severe menopausal symptoms,” says Prithwish De, a society epidemiologist.
If symptoms such as night sweats and fatigue can’t be managed any other way, then the therapies should be taken at the lowest dose and be terminated as soon as possible, says De, the study’s lead author.
The study was published Thursday in the U.S. Journal of the National Cancer Institute.
Use of hormone therapies in this country plummeted by 50 per cent in 2002 after a major international trial showed they produced increased risks for breast cancers, heart attacks and strokes.
In the ensuing two years, the incidence of breast cancer dropped 10 per cent, the study shows.
De says those lower replacement therapy levels have likely been maintained since in Canada and that a corresponding reduction in breast cancer has almost certainly resulted.
Many breast cancers depend on estrogen — one of two main hormones in the replacement therapies — to grow.
It’s felt that the link between the treatments and cancer is likely due to the elevated levels of estrogen menopausal women maintain with replacement treatments.
“We’re hoping that HRT use drops even more given that there are these risks, not just for breast cancer but for other conditions as well,” De says.
The study looked at all incidents of breast cancer in Canada between 2002 and 2004 in women aged 50 to 69.
In 2002, some 30 per cent of women in the age bracket were taking hormone therapies. This dropped to 15 per cent two years later.
Mammogram levels in Canada remained unchanged during that period, leaving hormone replacement as the only variable that could explain the drop, De says.
Dr. Pamela Goodwin, director of the Marvelle Koffler Breast Centre and a senior investigator at the Samuel Lunenfeld Research Institute of Mount Sinai Hospital, said the findings are a landmark for Canadian patients because it shows what is happening in a Canadian population. Similar results have been identified in the United States and United Kingdom.
“This is consistent with previous research,” said Goodwin, who was not involved in the study. “It indicates that hormone replacement therapy is associated with breast cancer risk, once again. The use of hormone replacement therapy should be avoided if possible. And if used, it should be in the lowest dose for the shortest period of time.”
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