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Re: Estrogen and breast cancer From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com) Mon Jul 26 10:27:32 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: In a Shift, Bush Moves to Block Medical Suits" Previous message: Richard Chudacoff, MD: "Re: In a Shift, Bush Moves to Block Medical Suits" In reply to: DoctorJoe@aol.com: "Re: Estrogen and breast cancer" Next in thread: Terrence.Jones@kp.org: "Re: Estrogen and breast cancer" Well, if you have a patient without adverse effects to ERT, then there is no concern regarding the therapy. Hence, the risks of the therapy are nil. However, if you do have a patient who develops breast cancer on ERT, then the risk of therapy is very real. I'm not aware of studies in vitro or in vivo that has suggested that estrogen is an initiator of breast cancer, but there are studies that implicate estrogen as a promoter of breast cancer. These cancers do tend to have more E/P receptors; therefore they are more amiable to SERM therapy. Non-estrogen related breast cancer tends not to be as responsive to SERMs. The latter tends to be more aggressive and fatal. Where is the flaw in my logic? No breast cancer: no concern for therapy. Cancer present: concern for therapy. If there is a concern for therapy, is it better to be on ERT or not on ERT. If therapy is not of a concern then the question is moot. -- Richard Chudacoff, MD Beer is living proof that God loves us and wants us to be happy. <http://www.brainyquote.com/quotes/quotes/b/benjaminfr109859.html> Benjamin Franklin Heaven grant that the burden you carry may have as easy an exit as it had an entrance. [Prayer To A Pregnant Woman] - <http://www.brainyquote.com/quotes/quotes/d/desiderius148996.html> Desiderius Erasmus _____ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of DoctorJoe@aol.com Sent: Saturday, July 24, 2004 11:36 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Estrogen and breast cancer In a message dated 7/23/04 09:39:39, rchudacoff@mylinuxisp.com writes: I am trying to break down the estrogen/breast cancer/WHI dilemma to its basic components, and have whittled it down to this question: assuming that a patient is GOING to get breast cancer (since if they don't, the whole issue of HRT is moot) is it better to be on estrogen or not on estrogen? I remember the JAMA article around 1998 (Trudy Bush I believe) which stated that women taking estrogen had a more well differentiated, therefore more treatable form of cancer than women who developed breast cancer not on estrogen. What are your feelings on this? If so, and breast women do better if they develop breast CA on HRT, would it not make sense to start, even if there are no menopausal symptoms? I'm wondering about the logic of discounting women if they're not "GOING to get breast cancer." I don't think the issue of estrogen is moot in any woman prospectively. The reason (I thought) that women who got breast Ca ON estrogen had better differentiated tumors is that it was possible the estrogen itself overly stimulated normal tissue to initiate carcinogenesis, while the women OFF estroge had "naturally occurring" cancer, which tended to be, well, more malignant (i.e. undifferentiated). So I don't know how the logic would go with YOUR line of thought here. Joe P. Next message: art fougner, md: "Re: In a Shift, Bush Moves to Block Medical Suits" Previous message: Richard Chudacoff, MD: "Re: In a Shift, Bush Moves to Block Medical Suits" In reply to: DoctorJoe@aol.com: "Re: Estrogen and breast cancer" Next in thread: Terrence.Jones@kp.org: "Re: Estrogen and breast cancer"

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