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Oestrogen Therapy Linked to Increased Risk of Benign Breast Disease BETHESDA, Md. -- April 8, 2008 -- Women who took the commonly prescribed conjugated equine oestrogen had more than twice the risk of developing specific types of benign breast disease as women who took a placebo, according to a randomised controlled trial published online April 8 in the Journal of the National Cancer Institute. The impact of conjugated equine oestrogen on the risk of developing benign proliferative breast disease, a condition that is associated with increased risk of breast cancer, has been unclear. Some studies have reported an association while others have not. In the Women's Health Initiative study, 10,739 postmenopausal women with hysterectomy were assigned to either conjugated equine oestrogen or a placebo. Previous analyses did not show an increase in breast cancer incidence in the women who took oestrogen alone after a median follow-up of 7 years. To determine whether the hormone increases the risk of benign proliferative breast disease, Tom Rohan, MD, PhD, Chairman, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, and Associate Director, Population Research, Albert Einstein Cancer Center, New York, and colleagues identified and examined noncancerous breast biopsies in each of the Women's Health Initiative trial arms. A total of 232 cases of benign proliferative breast disease were identified, with 155 cases among the women who took oestrogen supplements and 77 in the placebo group. The risk of developing benign disease increased by more than twofold for women taking conjugated equine oestrogen, compared with those taking a placebo. "The prevailing hypothesis concerning the natural history of breast cancer is that benign proliferative breast disease without atypia, proliferative disease with atypia, and in situ cancer represent successive steps preceding the development of invasive breast [cancer]. In keeping with this hypothesis, women with benign proliferative breast disease have an increased risk of subsequent breast cancer," the authors write. Although the women taking conjugated equine oestrogen have not yet shown a significant increased risk of breast cancer in the Women's Health Initiative study, if this hypothesis holds true, they might show increased risk later. Ongoing follow up of the study participants may help to resolve this issue. SOURCE: Journal of the National Cancer Institute E-mail this page to a friend or colleague! To print, use this version