U.S. Breast Cancer Rates Plunge

Experts Say Reduction In Use Of Hormone Pill May Be Linked To Dramatic Drop In 2003

(CBS/AP)  In a startling turnaround, breast cancer rates in the United States dropped dramatically in 2003, and experts said they believe it is because many women stopped taking hormone pills.

The 7.2 percent decline came a year after a big federal study linked menopause hormones to a higher risk of breast cancer, heart disease and other problems. Within months, millions of women stopped taking the pills.

A new analysis of federal cancer statistics, presented by researchers from the M.D. Anderson Cancer Center Thursday at a breast cancer conference in Texas, revealed the drop in tumors.

Why do doctors think the 2003 drop is largely due to hormones?

Cases declined most among women 50 and older, with tumors whose growth is fueled by estrogen — the age group and type of cancer most affected by hormone use. Around 2003, researchers said, these women heeded warnings and stopped using HRT — hormone replacement therapy.

But Dr. Freya Schnabel of New York Columbia Presbyterian says stopping hormone therapy may be just one reason for the dramatic decrease in breast cancer that year, reports CBS News correspondent Sharon Alfonsi. Better mammograms could play a part, too.

"If one thing is true," Schnabel tells Alfonsi, "it's that breast cancer is just not that simple."

"It's very difficult to wrap your arms around this subject of the various pros and cons of hormone replacement therapy," adds CBS News medical correspondent Dr. Jon LaPook.

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Dr. LaPook explains more about hormone replacement
Watch Alfonsi's report
FYI: Learn more about breast cancer

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About 200,000 cases of breast cancer had been expected in 2003; the drop means that about 14,000 fewer women actually were diagnosed with the disease.

The drop also was seen in every single cancer registry that reports information to the federal government.

Researchers looked for a similar drop in other cancers, which could indicate something other than hormones was at work, "and we didn't see anything," said Kathy Cronin, a National Cancer Institute statistician who worked on the analysis.

When the 2003 numbers were first released a few months ago, they were grouped with 2001 and 2002 and portrayed as a leveling off of breast cancer after decades of steady rise. The big single-year drop was not pointed out because experts did not want to make too much of it without knowing whether the trend would continue.

However, Dr. Peter Ravdin, a breast cancer specialist at the University of Texas M.D. Anderson Cancer Center who led the new analysis, said the single year drop is important regardless, because it was so huge and came after years of steady increases.

"We don't know about whether or not it's going to be a trend but we know for this year it was a significant effect," he said.

Doctors estimate that half of women who were taking hormones stopped after July 2002, when the federal Women's Health Initiative study was halted because more women taking estrogen/progestin pills developed breast cancer or heart problems.

That led to new warning labels on the drugs and doctor groups urging women to use the lowest dose for the shortest time possible.

"The hypothesis is entirely plausible, that the discontinuation of hormone replacement therapy could be having an effect," said Dr. Michael Thun of the American Cancer Society.

More than 8,000 breast cancer specialists from 80 countries are in San Antonio for the Charles A. Coltman Jr. Breast Cancer Symposium, the world's largest annual conference on breast cancer, which strikes 200,000 American women each year.

The next set of cancer statistics is due out in April.

[ktgrss]

HAS ANYONE CONSIDERED THE IMPACT OF THE PILL ON THE NUMBER OF BREAST CANCER PATIENTS AT ANY GIVEN TIME? I KNOW THAT WHEN MY MOM, WHO WAS BORN IN 1940, GOT ON THE PILL IN 1963, THE SCIENCE BEHIND THE PILL WAS NOT NEARLY AS REFINED AS IT WAS MUCH LATER, AND THE PILLS SHE TOOK CONTAINED A FAR GREATER CONCENTRATION OF ESTROGEN THAN DO THE LOW DOSE PILLS FROM TODAY.

[alishia3]

What about women like me who have had their ovaries and uterus removed? I am only 34 years old and have been on premarin for 10 years. My grandmother had breast cancer. What do I do? If I stop taking my estrogen I don't have ovaries to produce more and I am not at the age women usually go through menopause. I am so upset and angry because like the mother who was told hormones only likely caused uterine cancer, I was told the same exact thing. I would not have had both my ovaries removed if I had known. Now I feel stuck. What will my body be like with no estrogen? I was told the breasts only produce a negligible amount of estrogen. Even women who have gone through menopause still have ovaries that produce some estrogen. Heck my 82 year old grandmother who just underwent a histerectomy still had a functioning ovary! So my question is what do I do? I noticed during the interview this morning there was no mention at all of women who had had their ovaries removed. There never is! During any conversations with doctors on television who bring up hormone replacement and cancer, they never mention women like me and it is maddening. So what? The medical community has just thrown their hands in the air and to hell with us? let them get cancer? I feel abandoned and betrayed.

[alphaa10-2009]

Michdidi said, "Now that I am at the age where many women start taking hormone replacement there is no way I would risk my health taking hormones..."
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Not all hormones are the problem. The trouble comes from failure to realize all "hormones" are not the same, or bio-identical with what your own body needs, and what it would make, if it could.

Bio-identicals are exactly what the name implies-- identical to the molecular structure of your own hormones. From that vantage point, any other "hormone" is not really a hormone, at least, not one you want to buy in blind trust from the ever-enterprising pharmaceutical industry.

In principle, this applies to all drugs, not merely hormone substitutes. The FDA has been overly sympathetic to its drug industry clientele, to the point one recently disciplined FDA official was found to have stock in the very company whose trials and approvals he regulated.

American consumers are treated as paying guinea pigs by the pharaceuticals and aided and abetted by an overly plaint FDA. The FDA needs to end its days as a rest home for political hacks and start protecting American health-- the only purpose for which it was created.

[Michdidi]

My Mother had a hysterectomy in 1972. She then went on hormone replacement therapy for twenty years. In 1992 she developed breast cancer and had a double mastectomy. Mom's oncologist said that her cancer was caused by the hormones she had been receiving for twenty years. I remember when she started the hormone replacement in 1972 we asked about the safety of the hormone replacement. At that time they said that hormone replacement caused a higher rate of cancer of the uterus. Since Mom had her uterus removed when she had her hysterectomy we thought it was without risk to her. Now that I am at the age where many women start taking hormone replacement there is no way I would risk my health taking hormones.

[alphaa10-2009]

to dkdillon3 and tmo49150-- No one claims every breast cancer is a failure of a synthetic or substitute hormone (like Premarin), but the growing mass of evidence against use of synethetics and animal analogues suggests bio-identical hormones are the safest route.

For a discussion, see --

http://www.bio-identicalhormonesociety.com/hormone-testing-seminars.php

(be sure to use the entire, lengthy address above)

[alphaa10-2009]

ncolsens said, "... you would could live past 100, but then again, how boring would that be?"
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I'll check with you when you reach 100-- if you have lingered that long, you probably will want to stay.

[dkdillon3]

Oh, did I mention that I will be 60 on my next birthday?

[tmo49150]

I began HRT about 9 months ago. I'm 52 and very healthy with no history of cancer in my family. I have mamograms every year. I was shocked with I was diagnosed with hormone receptive breast cancer in October. Wished I had more information at the time I was making that decision.

[dkdillon3]

As a person diagnosed with breast cancer at 38 who underwent a mastectomy and heavy chemo and is currently in chemo for advanced metastatic breast disease, I can only say that hindsight is 20/20. We cannot expect the government to be our care taker. I would be dead if it not for the pharmaceutical companies. Does it mean they are always right? No, but sometimes they do get it just right. I think it's worth the risks.

[tmo49150]

I began hrt 9 months ago and was just diagnosed with estrogen positive breast cancer. I get my mamograms every year and there was no indication of anything last year. The surgeon told me while the hrt did not "cause" the cancer, it certainly fueled it. Wished I was better informed last year.

If you had never smoked, never drank, never ever took any kind of medications, ate right, and exercise regularly you would could live past 100, but then again, how boring would that be?

[estabwary]

The FDA needs to be inspected, dissected and reconstructed, because it is in no way shape or form, working for the citizens of this country.

The party is over.

[estabwary]

The FDA needs to be inspected, dissected and reconstructed, because it is in no way shape or form, working for the citizens of this country.

The party is over.

[estabwary]

The FDA needs to be inspected, dissected and reconstructed, because it is in no way shape or form, working for the citizens of this country.

The party is over.

[estabwary]

The FDA needs to be inspected, dissected and reconstructed, because it is in no way shape or form, working for the citizens of this country.

The party is over.

[alphaa10-2009]

This is yet another instance of the American public priding itself in having the "most innovative" medical science, then discovering they had only the most permissive federal regulation via FDA-- entirely more sympathetic and protective of its pharmaceutical industry clientele.

In effect, the risks of artificial hormone therapy were eventually prominent enough to stall marketing "great products" designed to mimic natural human hormones, but not before they had taken an unnecessary toll of breast cancers and made a bundle for the pharmaceuticals. l

Those women picketing the FDA about silicone breast implants need to direct their attention at the real villain-- the pharmaceutical industry's insistence on marketing a profitable commercial substitute of what they should have been taking in the first place, bio-identical human hormones. Bio-identicals have a drastically improved patient safety profile, but never got the attention of pharmaceuticals or (not by coincidence) the FDA.