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Postmenopausal HRT Linked To Certain Types Of Breast Cancer CHICAGO, IL -- June 8, 1999 -- Postmenopausal use of hormone replacement therapy (HRT) is associated with an increased risk of invasive breast cancer with a favourable prognosis, but there is little evidence of associations with the more commonly occurring ductal carcinoma in situ (DCIS) or invasive ductal or lobular cancer, according to an article in tomorrow’s issue of The Journal of the American Medical Association. Susan Gapstur, Ph.D., of Northwestern University Medical School in Chicago, and colleagues studied 37,105 postmenopausal women in the Iowa Women’s Health Study to determine if the use of HRT was associated with the subsequent occurrence of specific types of breast cancers. According to the researchers, despite the positive effects of HRT on reducing menopausal symptoms, reducing risk of osteoporosis and a potentially beneficial effect on primary prevention of coronary heart disease, concerns about breast cancer cause many women not to take estrogens. HRT's association with breast cancer is controversial. A considerable amount of epidemiological data supports a modest increase in risk of breast cancer with long-term hormone use. "We observed a positive, dose-response relationship between duration of postmenopausal hormone use and incidence of breast cancer with a favourable prognosis. This relationship appeared to be stronger for current users compared with past users," the researchers write. "Conversely, the incidence of DCIS and invasive ductal or lobular carcinoma were not related to ever use of hormones in this cohort. "The data, however, are suggestive of a modest increased risk of invasive ductal or lobular carcinoma among women who, at baseline, reported current HRT use for five or fewer years." The authors report that the risk of breast cancers with a favourable prognosis for women who ever used HRT for five years or less was 1.81 times greater than for women who never used HRT. Women who used HRT for more than five years had 2.65 times the risk. Although there may be several possible reasons for a specific risk association between HRT and invasive breast cancers with a favourable prognosis, increased medical surveillance cannot explain this observation because these tumours are not precursors for other types of invasive breast cancers, the authors explained. The authors agree that further study is needed and that these studies should explore more fully the differences in the association between types of postmenopausal hormones and breast cancer risk across tumour types. "If HRT use selectively increases the risk of the less commonly occurring tumours with a good prognosis, then the overall risks and benefits of hormone use in the population should be re-examined," the researchers write. Related Links: The Journal of the American Medical Association E-mail this page to a friend or colleague! To print, use this version