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Combined HRT raises breast cancer risk - study
WASHINGTON, Feb 15, 2000 (Reuters)


Taking combined hormone replacement therapy (HRT) raises the risk of breast cancer in women, but the risk is more than offset by lowered heart disease rates, researchers said on Tuesday. In what they called the most definitive study yet of breast cancer and HRT, a team at the University of Southern California said it found HRT increased the risk of breast cancer by 10 percent for every five years it was taken. Combined hormone replacement therapy, which adds the artificial female hormone progestin to the estrogen of HRT, raised the risk by 24 percent for each five years of use. the researchers reported in the Journal of the National Cancer Institute. For women taking estrogen alone, the risk of breast cancer rises 6 percent for every five years of use. Dr. Ronald Ross and colleagues at USC interviewed 1,900 breast cancer patients aged 55 to 72 and 1,600 similar women who did not have breast cancer living in Los Angeles in the late 1980s and early 1990s.

CANCER RELATIONSHIP PROBED HRT was used by about half the women in both groups. 'This study provides the most definitive and detailed data yet available on the relationship between combined hormone replacement therapy use and breast cancer risk,' they wrote. Hormone replacement therapy is prescribed to relieve the symptoms and consequences of menopause, which range from hot flashes to osteoporosis. But estrogen-only HRT (ERT) was soon shown to raise the risk of breast cancer and cancer of the endometrium, the lining of the uterus. So some HRT was reformulated to add progestin, a synthetic version of progesterone. Studies have been conflicting on whether the combined HRT lowers the risk of both breast cancer and the very rare endometrial cancer. Ross's team says its study goes a long way toward answering that question. 'If the main purpose for prescribing combined HRT is to protect the endometrium from the carcinogenic effects of estrogen, then this study would argue that the adverse effect on the breast may outweigh the beneficial effect on the endometrium, at least in terms of cancer,' they wrote.

CONSULT WITH DOCTORS 'Women who are candidates for HRT should be provided with this information,' they added -- and they said doctors should explain that the definitive answer is not there yet. They pointed out that ERT strongly reduces the risk of heart disease, which kills far many more women than breast cancer does. 'We have calculated that, for each incident case of breast cancer in women due to long-term ERT use, more than 6 deaths from heart disease are prevented,' they wrote. Women taking ERT are much less likely to die of anything at the same age as women not taking it, they added. Last month, Catherine Schairer of the National Cancer Institute and colleagues published a paper in the Journal of the American Medical Association showing that women who were using or had recently used the combination progestin-estrogen therapy had a 40 percent higher risk of developing breast cancer.

They looked at 15 years of data on 46,355 women.

Copyright 2000 ABC News Internet Ventures.

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