latest contribution to the ongoing discussion of HRT and breast cancer

[Lani]

Implicates long term (>10 years) HRT use in increased risk of breast cancer even when Estrogen only HRT is utilized (remember this group had hysterectomies and were nurses ?perhaps had night shifts) so they may not be typical!:

Long-term HRT 'ups cancer risk'

Hormone replacement therapies come in a number of forms
Long-term use of oestrogen-only hormone replacement therapy (HRT) does increase the risk of breast cancer, a major study suggests.
The US study comes just weeks after research appeared to rule out any connection in the short to medium term.

Oestrogen-only HRT is usually reserved for women who have had hysterectomies, as it increases womb cancer risk

The latest study, published in Archives of Internal Medicine, examined data on nearly 29,000 women.


Women should be aware that not all the causes of breast cancer are known and it's likely to be a combination of several factors which interact to increase risk
Emma Taggart

Research has suggested that HRT using a combination of the hormones oestrogen and progestogen may increase the risk of breast cancer.

And some studies have also suggested a similar risk is associated with the oestrogen-only form.

However, a study of more than 10,000 women by Stamford University published last month found no evidence of any increased risk in women who used the therapy for up to seven years.

The latest study, by Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, followed a group of female nurses who took part in a long-term study which began in 1976.

Throughout the study period, 934 women developed invasive breast cancers. Of these 226 had never used hormones, and 708 had used oestrogen therapy.

The longer a woman used oestrogen, the higher her risk of breast cancer appeared to be.

Those who had been taking oestrogen for fewer than 10 years did not appear to have a higher risk than those who had never taken hormones.

But those who had been taking the hormone for more than 20 years had a significantly increased risk.

Many factors

Henry Scowcroft, of the charity Cancer Research UK, said it was likely that that oestrogen-only HRT slightly increased a woman's chances of breast cancer when used over a long period.

He said a major study by the charity published in 2003 estimated that over 10 years, oestrogen-only HRT would lead to five additional breast cancers for every 1,000 women taking the treatment.

This compared with an estimated extra 19 breast cancers per 1,000 women taking combined HRT.

But he added: "HRT still remains an effective short-term treatment for relief of menopausal symptoms."

Emma Taggart, of the charity Breakthrough Breast Cancer, said: "Women should be aware that not all the causes of breast cancer are known and it's likely to be a combination of several factors which interact to increase risk.

"Whether to start or continue taking HRT needs to be an informed choice made with the help of a GP and should be reviewed every year."

Liz Carroll, of the charity Breast Cancer Care, agreed that women should discuss treatment options with their doctor.

But she added: "All women should be breast aware, by knowing how their breasts normally look and feel and reporting any changes immediately.

"The risk of breast cancer increases with age whether you take HRT or not."

[Lani]

here the risk is less when used <10 years and greater when used >20 years--and that the risk with use over 20 years is greater for thin women than obese women

Remember in all this they are lumping ALL breast cancer together as if it is one disease- any and all of this may or may not hold trye for her2neu+ breast cancer, which is a thing unto itself:


HEALTH JOURNAL
By TARA PARKER-POPE
• Health
The Breast Cancer Link: Study Offers
Insight Into Long-Term Estrogen Use
May 9, 2006; Page D1
New data on estrogen show the risk of breast cancer is lower than previously believed and begin to answer questions about how long women can safely use the hormone.

The research, from Harvard University's Nurses' Health Study, is the latest piece of the increasingly complicated estrogen puzzle. The study looked at estrogen use among 28,835 nurses and whether long-term use affected risk for breast cancer.

HEALTH MAILBOX


Email healthjournal@wsj.com, and read Tara Parker-Pope responses in Health Mailbox.
The study showed there was no statistically significant increase in breast cancer risk with up to 20 years of estrogen use. But after 20 years of use, the risk of breast cancer jumped by 42%, according to the report published today in the Archives of Internal Medicine. The data also suggested that the breast cancer risk may be slightly lower during the first 10 years, but there weren't enough cancer cases among the women studied to make the number statistically reliable.

The data, which paint the clearest picture to date about how long a woman can use estrogen without increasing her risk for breast cancer, should be reassuring to the majority of women using hormones to relieve hot flashes and other symptoms of menopause. Of the 4.4 million U.S. women who use menopause hormones today, about 3.5 million take only estrogen. An additional 900,000 women take a combination of estrogen and progestin. (Progestin is added to blunt the effects of estrogen on the uterus and prevent endometrial cancer. Women take estrogen by itself if they've had a hysterectomy.)

Twenty years is far longer than most women today are advised to take hormones. Although duration of use varies, most doctors suggest women limit hormone use to less than five years.

But as many as 10% of menopausal women may still suffer debilitating symptoms for several years after menopause, requiring them to stay on the drugs longer. Other women who might require long-term use are those in their 30s and 40s who experience surgically induced menopause, caused by removal of their ovaries. To prevent a debilitating drop in estrogen, these women may need to stay on the drugs for 15 to 20 years until the time of natural menopause.

"This is reassuring to women who are contemplating taking estrogen alone for 10 to 15 years," says study author Wendy Chen, researcher at Brigham and Women's Hospital in Boston. "There are also a lot of women who went through menopause in the '70s and '80s who have been on estrogen for a long period of time. The question is should they still remain on estrogen?"

While the latest research is good news for most women using menopause hormones, it continues to raise questions about progestin and whether it's the real culprit in many of the health risks recently associated with hormone use. Studies have shown that using estrogen and progestin in combination is linked with a slightly higher risk of breast cancer after about five years of use.


The new data from the nurses' study are also consistent with a controversial finding of the government-funded Women's Health Initiative. The WHI reported in April that using estrogen for an average of seven years didn't increase the risk of breast cancer and may even have lowered it. The study shocked the medical community because it contradicted decades of earlier research that suggested estrogen was linked with a higher risk for breast cancer.

But one big problem with the WHI is that it was stopped a year early, because government health officials cited a slight increase in stroke risk among older women in the study. The WHI investigators lamented that year of lost data because it would have added credibility to the surprising finding.

Now the Nurses' Health Study has looked at the estrogen-breast cancer link for far longer than a clinical trial could ever do. The nurses study is an observational study that tracks the health habits of women over time without dictating any particular treatment. A clinical trial, like the WHI that compares a treatment to a placebo, is far more expensive to conduct for long stretches of time.

"There isn't ever going to be a clinical trial in which women will take estrogen for 15 or 20 years," says Dr. Chen. "It's a relevant question to women who are currently on estrogen, and they're deciding 'How long should I remain on it?'"

Most of the nurses' data before the 20-year mark didn't reach the point of statistical significance, meaning the findings could just be due to chance. The data showed that breast cancer risk was about 10% lower in the first 10 years of estrogen use, but the risk increased slightly over the next 10 years, but none of those findings were statistically meaningful because there were so few cancer cases among the women studied.

The 20-year mark was the first point in time when the data showed a statistically significant link with breast cancer. The investigators noted that among cancers that have hormone receptors for both estrogen and progesterone, which account for 44% of the cases studied, the risk for breast cancer increased sooner, at the 15-year mark.

Another important finding of the study showed that estrogen use for 20 years or more poses a higher risk to thin women than overweight women. The theory is that overweight women have more natural circulating estrogen from body fat, so hormones in a pill are less of a shock to the system than in a thin woman. The nurses' data showed that after 20 years of use, thin women had a 77% higher risk for breast cancer compared with thin women who didn't use hormones. Overweight women had a 25% higher risk after 20 years compared with overweight women who didn't use hormones.

[AlaskaAngel]

(endocrine system.... endocrinology... hormonal balance... )

So who needs endocrinologists?... as part of the big picture... WE DO... but how many of us have had our treatment impacted by the influence of endocrinologists? How many of us have seen one as part of our treatment? Is this ridiculous or what....
AlaskaAngel