Menopause news

Progestin Increases Breast Cancer Risk More Than Oestrogen.

2003

A study recently reported in Cancer, investigated the incidence of breast cancer and HRT use in 29,508 women, randomly selected from a population of 40,000 from 1990 to 1992 and followed through to December 2001. The women were aged 25 to 65 and during the study there were 556 cases of breast cancer. Risk was significantly increased in women who took HRT containing oestrogen and daily progestogen (continuous combined). There were no significant increases for women taking oestrogen with cyclical progestogen (sequential combined) and oestrogen only. Five years after stopping HRT there was no increased risk.

Comment

It appears that oestrogen only HRT has very little breast cancer risk but that HRT containing continuous progestogen is more hazardous. Women who have had a hysterectomy would usually take oestrogen only HRT but other women taking HRT are advised to use combined therapy since with an intact uterus, oestrogen only has been shown to increase endometrial cancer risk. Women who are postmenopausal are often offered a continuous combined preparation since this offers the benefit of no bleeding and reduced risk of endometrial cancer compared to sequential therapy. For each woman, treatment should be individualised and the benefits weighed against the risks.
Cancer.2003;97(6):1387-1392

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