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HRT & Breast Cancer From: Joanne Bulley, MD (islesannie@yahoo.com) Tue Oct 28 16:44:10 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. Ainsworth: "Methadone in pregnancy" Previous message: Joanne Bulley, MD: "Re: CIN & IUD" The talks I have listend to - David Archer and Hugh Taylor - recently have continued my review of the HRT data to show that it ain't all bad. My assessment is that the benefits (even if you only consider BMD - or only sexual function) outweigh the risks - IF you start it before 5 years. Here's another one - with iproved breast cancer prognosis. -- Joanne Reported in Reuters: (on the http://www.medscape.com/viewarticle/463405 site) Mortality Rates Lower for Breast Cancers Linked to HRT Use NEW YORK (Reuters Health) Oct 23 - The risk of invasive lobular carcinoma (ILC), the type of breast cancer most commonly associated with use of combined hormone replacement therapy, has increased over the last three decades. However, the prognosis for ILC has improved relative to that of invasive ductal carcinoma, the most common type. The results of previous studies that compared the prognoses of different histologic types of breast cancer have been inconsistent, note Dr. Christopher I. Li, at the Fred Hutchinson Cancer Research Center in Seattle, and colleagues. But few studies have been population based, and the studies included relatively small numbers of cases with rare histological types. To further clarify the prognoses of different types, Dr. Li's group conducted a retrospective cohort study using data from the nine cancer registries of the Surveillance, Epidemiology and End Results (SEER) program. Included were nearly 165,000 women ages 59 to 79 years old when diagnosed with a primary invasive breast cancer between 1974 and 1998. Approximately 80% had ductal, 12% had lobular and 2.4% had mucinous carcinomas, they report in the October 13th issue of the Archives of Internal Medicine. Between 0.6% and 1.9% had comedocarcinomas, medullary, tubular or papillary carcinomas. Only the number of cases of medullary carcinoma declined over the course of the study. After adjusting for age and year of diagnosis, SEER historic stage and category, and treatment (surgical and/or radiation), the prognosis remains the worst for women with invasive ductal carcinoma. Mortality rate declined the most for women with tubular carcinomas (34%). Between 1994 and 1998, the risk of mortality associated with mucinous carcinoma and invasive lobular carcinoma dropped 31% and 26%, respectively, compared with women with invasive ductal carcinoma. Dr. Li and associates suggest that improved survival may be due to changes in hormonal therapy and chemotherapy. "It appears that the types of breast carcinomas combined HRT users have a greater risk of developing, such as invasive lobular carcinoma, have a relatively favorable prognosis," they conclude. Arch Intern Med 2003;163:2149-2153. -- Joanne Bulley, MD Keene, NH, USA ----- Work to create peace everywhere you go and with everything you do. ----- Let us accept truth, even when it surprises us and alters our views. -George Sand Next message: Dr. Ainsworth: "Methadone in pregnancy" Previous message: Joanne Bulley, MD: "Re: CIN & IUD"

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