Charles L. Shapiro, MD
Charles L. Shapiro, MD, Professor of Medicine, Hematology and Oncology at the Icahn School of Medicine at Mount Sinai, New York, commented on the Women’s Health Initiative update. “These trials involved more than 27,000 women between the ages of 50 and 79. The women with a uterus were randomly assigned to conjugated equine estrogen and medroxyprogesterone acetate/placebo, whereas the women without a uterus were randomly assigned to estrogen/placebo alone. After about 16 years of median follow-up, the women treated with estrogen had a 23% decreased risk of developing breast cancer (P = .005). In contrast, with about 18 years of median follow-up, the women treated with estrogen/progestin had a 21% increased risk (P < .001).”
“These findings of a decreased risk of breast cancer with estrogen have been previously reported,” Dr. Shapiro continued. “The new findings are that the effect of a decreased risk extends well beyond the treatment period (a median of about 7 years). Likewise, the increased risks of breast cancer in women treated with estrogen and progestin extended well beyond the treatment period (of about 5 years),” noted Dr. Shapiro. “As soon as the Women’s Health Initiative findings were reported, the long-term use of hormone replacement therapy (ie, estrogen and progestin, and estrogen alone) decreased greatly. It is reassuring for women with intractable menopausal symptoms that short-term therapy with estrogen alone has decreased the risk of breast cancer.”
DISCLOSURE: Dr. Shapiro reported no conflicts of interest.
In postmenopausal women without prior breast cancer, estrogen alone reduced the risk of breast cancer, not only during treatment, but for years after estrogen was stopped. It also reduced deaths as a result of breast cancer and deaths after breast cancer from all causes. However, in contrast,...