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Re: ERT in Breast Cancer PatientsFrom: Zach Newton (zbnewton@atl.mindspring.com)Tue Dec 17 18:48:37 1996
HMarchbein@aol.com wrote: > > Our breast surgeons and medical oncologists are vehemently oppposed to ERT in > Breast Cancer patients. What literature is anyone using to present to their > patients in favor of this very important therapy. I've presented an > occasional article but have hit a brick wall with the others MDs involved. Paired Pro/Con articles on HRT in cancer survivors are included in the November/December issue of "CA:A Cancer Journal For Clinicians," 1996; 46:343-363 & 365-373. Published by American Cancer Society. The lead author of the Pro article is Harriet O. Smith, M.D., Onclologist, Dept Ob/Gyn, Univ of New Mexico. Bibliography: 152 citations. It should be noted that the most recent citation is 1995. We can all recall that a number of papers with opinion and some data have been published this year. The Con article is authored by Carolyn D. Runowicz, MD, Oncologist, Dept Ob/Gyn, Albert Einstein College of Medicine. Bibliography: 36 citations. Dr. Smith makes reference to ACOG Committee Opinion 135, 1994. "ACOG advocates prescribing ERT on an individual basis after fully informing patients of known benefits and possible risks." Comment: The trend toward selective use of ERT/HRT in postmenopausal survivors of breast cancer has been in place for several years with momentum gaining. As the majority of this population that I see are on tamoxifen for the first 5 years post primary therapy, I discuss the option with selected candidates after completion of the course of tamoxifen. These patients are followed by myself, an oncologist and, in the vast majority, the surgeon who was involved in primary therapy. Office notes and results of any studies are exchanged. I have no data, but discontinuation of ERT/HRT in this group has been exceptional. My impression is somewhat distorted by the fact that an unknown number of those that discontinue do not return to me for gyn follow-up.
-- Zach Newton Z. B. Newton, III, M.D. Atlanta Gyn
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