Re: ERT/HRT- personal prescribing trend

From: Joanne Bulley, MD (islesannie@yahoo.com)
Fri Oct 18 21:36:32 2002

Thanks Mark -

I missed that particular article (CRP) and comments form others may have addressed that but I missed it.

My take on the breast is that since the going knowledge of breast cancer is that it takes 8+ years for the cancer to get from a single cancerous cell to a diagnosible cancer. So if the WHI lasted 5.2 years (average) we are only seeing those cancers that were (probably) there already -- NOT new ones "caused" by the "treatment".

Also - those saying HRT was "bad for the breast" always said it was the estrogen - so ... gee ... the Premarin only arm is still going on - so the issue of cause versus stimulating one that was going to be ther anyway needs a thoughtful evaluation.

The C Reactive Protein conection is of vital interest here.

I agree - we need to continue to re-evaluate the data in order to make an Evidence Based Set of Recommendations!

Joanne

At Fri, 18 Oct 2002, Mark Perloe wrote: >
>Zach,
>Please read the followup paper in JAMA two weeks later that revisited the
>WHI data set.
>In that paper, they noted that if the study group and control groups were
>controlled for CRP, a known cardiovascular risk factor, there was no longer
>an increased risk in the estrogen treatment group.
>This means that perhaps we need to consider CRP, homocysteine, And maybe
>Factor V Leiden if there is increased stroke risk. Overall, the WHI did
>show lower mortality. Less colon cancer. And, the issue of breast cancer
>mortality was not addressed, just the increased of new cases during a brief
>period of the study.
>Mark Perloe

--
Joanne Bulley, MD
Keene, NH, USA



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