ERT/HRT and breast cancer deaths

From: STEWART PRINGLE (100724.2333@CompuServe.COM)
Tue Dec 17 16:54:18 1996

I got hold of the paper I alluded to in an earlier post ( the journal is not held by any library in Scotland, nor has the article got to the ACS web site yet). The abstract is given below. It's nice to know that RCT's are ongoing which will provide better answers than we have at present on these issues but in the meantime I find the data below pretty reassuring and will try to use it to guide patients. BUT how do you tell someone that they're more likely to get breast ca but less likely to die from it (and expect them to believe you?) 

--
Stewart Pringle
Glasgow, UK
100724.2333@compuserve.com


Estrogen replacement therapy and risk of fatal breast cancer in a prospective
cohort of postmenopausal women in the United States


Dawn B Willis et al


This study examines the relationship between fatal breast cancer and use of
estogen replacement therapy (ERT) among women in a large prospective study in
the US. After 9 years of follow-up, 1469 breast ca deaths were observed in a
cohort of 422 373 postmenopausal women who were cancer free at study entry and
who supplied information on estrogen use. Results from Cox proportional hazards
modeling, adjusted for 11 other potential risk factors, showed that ever-use of
ERT was associated with a significantly decreased risk of fatal breast ca (RR
0.84, 0.75-0.94). There was a moderate trend (p=0.07) of decreasing risk with
younger age at first use of ERT. This decreased risk was most pronounced in
women who experienced natural menopause before the age of 40 years (RR 0.59,
0.4-0.87). There was no discernible trend of increasing risk with duration of
use in estrogen users at baseline of former users, nor was there any trend in
years since last use in former users. The relationship beteween ERT and breast
ca mortality differed by age at menarche and by a self-reported history of
breast cysts. No increased risk of fatal breast ca with ERT was observed with
estrogen use status (baseline/former), age at first use, duration of use or
years since last use. These findings suggest that ever-use of ERT is associated
with a 16% decreased risk of fatal breast ca.
Cancer Causes and Controls, 1996, 7, 449-57



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