HORMONE REPLACEMENT THERAPY AND BREAST CANCER – NEWS ANDRECOMMENDATION

BACKGROUND HT should be considered only when an indication for therapy has been clearly identified,contraindications ruled out, and the potential individual benefits and risks adequatelydiscussed with the women so that an informed decision can be made.Breast cancer risk increases with EPT use beyond 5 years. In absolute terms, this increasedrisk are rare in the WHI, being 4 to 6 additional invasive cancers per 10.000 women peryear who used EPT for 5 or more years. Studies have not clarified whether the risk differsbetween continous or sequential use of progestogen. Women in the ET arm of the WHIdemonstrated no increase in risk of breast cancer after an average of 7.1 years of use, with8 fewer cases of invasive breast cancer per 10.000 women per year of ET use. There arelimited observational data suggesting that ET for more than 15 years may increase the riskof breast cancer. There are minimal data reporting any change in breast cancer mortalitywith HT. CONCLUSIONS It should be recognized that even in the absence of HT use, there is a risk of development ofbreast cancer. There are multiple risk factors for breast cancer, including alcohol intake,obesity and lack of exercise. These need to be included during counselling to put the magnitude of risk of HRT into an appropriate perspective