Re: Menpause Question
From: art fougner, md (evsono@pipeline.com)
Tue May 8 21:45:54 2001
the problem with all studies assessing risk factors for breast cancer is
that there is no guarantee that the populations have the same basline
risks. with the rapid expansion in the field of genetics, BRCA
mutations merely being the tip of the iceberg, all studies will need to
be redone.
art
At Tue, 8 May 2001, Dr. Rupak Ranjan Roy wrote:
>
>So, lower the dose of Provera, more the risk of breast cancer?
>But, as far as I remember, the study that looked into progestogens and
>breast cancer found a higher incidence of breast cancer in women who
>received higher dose of progestogen.
>
>--
>Rupak Ranjan Roy
>MRCOG
>
>>----- Original Message -----
>From: "Denise Sobel" <dsobel@vom.com>
>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.medispecialty.com>
>Sent: Wednesday, May 09, 2001 2:44 AM
>Subject: Re: Menpause Question
>
>> As I stated before, I said I would get back to you regarding
>> how progesterone enhances estrogen receptors. I was
>> given permission from David Zava, PhD. to send this
>> quote to you. Dr. Zava has done 20+ years of research in
>> the breast cancer field. I am not trying to start
>> a flame war, and I am not admitting I know all the scientific
>> roles of progesterone, I am still learning, too.
>>
>> "Progesterone has a dual role in controlling estrogen-mediated
>proliferation.
>> At low concentration it synergizes with estrogen to increase
>> estrogen-mediated cell proliferation but at a higher concentration
>> progesterone induces the estrogen-stimulated cells to specialize, or
>> differentiate. The uterus and breast are two good examples of the
>biphasic
>> actions of progesterone. In the breast during the first week or so of the
>> luteal phase, as progesterone is rising, estrogens and progesterone
>> coordinate a burst of cell proliferation that is followed by
>differentiation
>> of the ducts to lobules, a more differentiated form.
>>
>> If progesterone is
>> inadequate, as with luteal insufficiency or (I believe) with synthetic
>> progestins like Provera (I see many women on Provera with fibrocystic
>breasts
>> and we know this increases breast cancer risk), breast cells just continue
>to
>> proliferate and never differentiate. Clinically this is seen as
>fibrocystic
>> breasts."
>>
>> Denise Sobel, R.N.
>> N. Calif.
>>
>> Robert J Woolley wrote:
>>
>> > Ah, a popular press book. What is the reference given for that claim? If
>> > none, on what basis do you conclude that it is correct?
>> >
>> > On Fri, 4 May 2001, Denise Sobel wrote:
>> >
>> > > Natural Progesterone, The Multiple Roles of a
>> > > Remarkable Hormone, by John R. Lee, M.D.
>> > > 1993 (and recently revised)
>> > >
>> > > "Progesterone enhances receptor sensitivity of
>> > > estrogen." page 36
>>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
