Hormone Therapy-Breast Cancer Tie Grows

Five Years Of Still-Popular Postmenopause Hormone Treatment Doubles Breast Cancer Risk

(AP)  Taking menopause hormones for five years doubles the risk for breast cancer, according to a new analysis of a big federal study that reveals the most dramatic evidence yet of the dangers of these still-popular pills.

Even women who took estrogen and progestin pills for as little as a couple of years had a greater chance of getting cancer. And when they stopped taking them, their odds quickly improved, returning to a normal risk level roughly two years after quitting.

Collectively, these new findings are likely to end any doubt that the risks outweigh the benefits for most women.

It is clear that breast cancer rates plunged in recent years mainly because millions of women quit hormone therapy and fewer newly menopausal women started on it, said the study's leader, Dr. Rowan Chlebowski of Harbor-UCLA Medical Center in Los Angeles.

"It's an excellent message for women: You can still diminish risk (by quitting), even if you've been on hormones for a long time," said Dr. Claudine Isaacs of Georgetown University's Lombardi Comprehensive Cancer Center. "It's not like smoking where you have to wait 10 or 15 years for the risk to come down."

Study results were given Saturday at the San Antonio Breast Cancer Symposium.

They are from the Women's Health Initiative, which tested estrogen and progestin pills that doctors long believed would prevent heart disease, bone loss and many other problems in women after menopause. The main part of the study was stopped in 2002 when researchers saw surprisingly higher risks of heart problems and breast cancer in hormone users.

Since then, experts have debated whether these risks apply to women who start on hormones when they enter menopause, usually in their 50s, and take them for shorter periods of time. Most of the women in the federal study were in their 60s and well past menopause.

So the advice has been to use hormones only if symptoms like hot flashes are severe, and at the lowest dose and shortest time possible. The new study sharpens that message, Chlebowski said.

"It does change the balance" on whether to start on treatment at all, he said.

Even so, most women will not get breast cancer by taking the pills short-term. The increased cancer risk from a couple of years of hormone use translates to a few extra cases of breast cancer a year for every 1,000 women on hormones. This risk accumulates with each year of use, though.

---

See the findings of the Women's Health Initiative study on postmenopausal hormone use.

---

The Women's Health Initiative study had two parts. In one, 16,608 women closely matched for age, weight and other health factors were randomly assigned to take either Wyeth Pharmaceuticals' Prempro - estrogen and progestin - or dummy pills.

This part was halted when researchers saw a 26 percent higher risk of breast cancer in those on Prempro.

But that was an average over the 5½ years women were on the pills. For the new study, researchers tracked 15,387 of these women through July 2005, and plotted breast cancer cases as they occurred over time.

They saw a clear trend: Risk rose with the start of use, peaked when the study ended and fell as nearly all hormone users stopped taking their pills. At the peak, the breast cancer risk for pill takers was twice that of the others.

Think of it as President George W. Bush's public approval rating, said another study leader, Dr. Peter Ravdin of the University of Texas M.D. Anderson Cancer Center in Houston.

"Bush's popularity may be 50 percent on average, but it might have been descending the whole time he was president," Ravdin said.

In the second part of the federal study, researchers observed just 16,121 women who had already been on hormones for an average of seven years and another group of 25,328 women who had never used them. No results on breast cancer risk in these women have been given until now.

Plotting cases over time, researchers saw in retrospect that hormone users had started out with twice the risk of breast cancer as the others, and it fell as use declined. Among those taking hormones at the start of the study, use dropped to 41 percent in 2003, the year after the main results made news.

In the general population, use of hormone products has dropped 70 percent since the study, said another of its leaders, Dr. JoAnn Manson, preventive medicine chief at Harvard's Brigham and Women's Hospital in Boston.

That corresponds with big drops in breast cancer cases, but some scientists have said this could be due to a fall-off in mammograms, which would mean fewer cancers were being detected, not necessarily that fewer were occurring.

The new study puts that theory to rest. Mammography rates were virtually the same among those taking hormones and those not.

"It is clear that changing mammography patterns cannot explain the dramatic reductions in breast cancer risk," Manson said.

"The data are getting stronger," said Dr. C. Kent Osborne, a breast cancer specialist at Baylor College of Medicine in Houston.

Women who do need the pills should not panic, though the doubling of risk - a 200 percent increase - for long-term users is quite worrisome, cancer specialists say. Although the new study does not calculate risks in terms of actual cases, previous research showed that the average increased risk of 26 percent meant a difference of a few extra cases a year for every 1,000 women on hormone pills, compared with nonusers.

"Hormone therapy remains a good health care choice to relieve moderate to severe menopausal symptoms," says a statement from Wyeth, which made the pills used in the study.

"Most women should be able to discontinue hormones in three to four years," or at least reduce their dose, Manson said.

A future analysis will look at other women in the study who took only estrogen, generally women who have had hysterectomies.

[mntrosie]

indivthinker says the problem is that estrogen is a cancer producer. yes...BUT...this is not human estrogen they are talking about. its HORSE estrogen. it has shown to be a far greater problem. bio-identical estrogen and plant based estrogens are not showing to cause the same problem. And i would like to mention that to produce Prempro and premarin they keep horses stalled in inhumane conditions for 9 months of the year. they give birth and are immediately impregnated again. the foals are slaughtered for dog food. nearly 100,000 a year. over 10 million in the history of the drugs. All to keep us from feeling a temporary natural discomfort and with a great risk of breast cancer.

[sepa2]

Hormone therapy was designed by men for the benefit of men....Ladies, is it worth getting breast cancer for just so you can please your man??
------------------------
Usual sexist rubbish. For better or worse Whole homone therapy started because of feminist activits. Billions have been spent on issues related to this. First to study benefits and now to study side effects

[tincup356]

the FDA is using American people for lab rats to see what combinations of drugs will kill us off faster.Our government is poisoning us...look at Aspartame,,,it was invented for use as chemical warfare...and now thy put it in everything steadily trying to poison the people...it ''s all brought to you as part of the war on the middle class.

[quartersaw]

The estrogen sold by Big Pharm is *not* chemically identical to human estrogen. The reason for this is if they used the identical
human estrogen molecule, they would not be able to patent the drug, and consequently would not make much money from it. As a result, the prescription estrogen is slightly different/patentable so the drug companies can make megabucks from it..

[indivthinker]

Doctors and the Pharmaceutical industry should be sued to the max.

Posted by jntlw at 09:49 PM : Dec 13, 2008

Why is it that drug companies should be sued for producing a NATURAL chemical? Estrogen is what the doctors usually supplement for women to avoid menopause. It is a naturally produced chemical (not some drug company scheme to kill you) that was manufactured by the pharmaceutical companies because there was demand by the people to have it.

Estrogen itself is a promoter of cancer. It in itself does not cause cancer, but it makes the cells in the breast more susceptible to become mutated by a mutagen or a real cancer causing chemical.

So why don''t you stop your whining and read up on the subject. Instead of screaming SUE SUE SUE, do your own research and stop blaming "Big Pharma" for all your problems. Pharmaceutical companies are not evil. They produce products for enhancement of people''s lives, just like computer and car companies do. Just because a pill has side effects does not give you a right at all to sue for money. You should be prepared for ANY risk when you take meds, even if it is not mentioned on the bottle.

Gosh, no wonder health and medical malpractice insurances are so high. We have so many morons in this country that think it is okay to just sue for damages. Grow some balls.

[tincup356]

the FDA is a joke they accept test data from the people who make the drugs...of course they''re not going to find anything wrong and keep some billion dollar medication off the market , they don''t care what it causes or side effects.for too long the pharmaceutical companies and the FDA have been lying to the people and playing the lobby game.Any more the best treatment for most things is no treatment, at least not what they say they have tested and didn''t.

[grammawhamma]

To those of you who developed breast cancer...I wish you the best.

[grammawhamma]

People should let nature take its course. Hot flashes are uncomfortable but they don''t kill you!

[daisyjingles]

I took hormone replacement therapy and got breast cancer. When I reread the instructions that had come with the medicine, it warned that it might cause breast cancer. I just did not think it would happen to me. Statistics mean nothing when you are the one it happens to. I had to have a complete mastectomy on one side. As of today I am a two year and four month survivor. You never forget the day you are diagnosed with cancer.

[dragontat2]

I''m with you, jntlw. The pharmaceutical industry is most concerned with their bottom line, not whether or not the studies are accurate.
My doc gave me hormones post hysterectomy [and evil hot flashes] and within a week I was having heart palpitations. I immediately stopped the hormones, learned about and used natural remedies. Black cohosh [sp], etc. I avoid pharmaceuticals totally now.
Best of luck to all the women reading this. There ARE alternatives to un-natural drugs!

[jntlw-2009]

Doctors and the Pharmaceutical industry should be sued to the max. I refused HRT and my doctor actually got mad at me, but I would not take it. My gut feeling was they were lying about what it can do. Guess my gut feeling was right, but for millions of women my age (baby boomers who listened to their doctors advise - they should demand retribution). never but never trust drug companies nor any doctors who push drugs.

[cdfoxtrot6]

Isn''t HRT based on horse urine, and the process of getting it is widely considered cruel? When pharma companies keep dick1ng around with nature like this, it''s hardly a surprise that bad things happen.

[stargate1121]

I took estrogen after my hysterectomy for a long time and the dr.finally took me off of it and then after being off if for quite awhile I was diagnosed with breast cancer. wish I had known about the estrogen sooner because it was an estrogen based tumor the dr. said,and maybe I wouldn''t have gotten it.

[Marie Zarankevich]

Thank Goodness SOMEBODY is finally doing CURRENT figures on some of these things everyone''s been wondering about for so long. -- It''s about darned TIME. -- We all keep assuming that medical science is up to date, and that couldn''t be farther from the truth. -- The entire field needs a HUGE amount of updating and current research, just to catch up. -- And SOON.