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You've probably all read about the latest two articles that came out this week critical of "Combined Hormone Therapy" (CHT) i.e. when you take 'two' hormones - an estrogen and a progestin.
The first article was a further analysis of the same patients from last years Woman's Health Initiative (WHI) and had some new findings. First it suggested that the increase in breast cancer showed up after 3 years rather than the previously suggested 4 years. Also hormone therapy caused more abnormal mamograms after one year. Now noone ever died of an abnormal mamogram but it does lead to unnecessary anxiety and stress. Also the tumors in the Prempro group were larger and a little more advanced when they were diagnosed. The relative risk was the same as before, 1.24, and this new analysis did not apply to woman who used only an estrogen or who used a hormone patch. No mention was made of mortality rates.
The second article was a "population-based, case-control study." In the past these types of studies have been criticized for being biased regarding who chose to take hormones. Anyway it found that women over age 65 who take combined hormone therapy had a 2.0 relative risk of getting breast cancer. Interestingly, it also found that Women who used only estrogen (as opposed to estrogen plus progestin) for 25 years or longer had no significant increase in risk of breast cancer.
As I see it, these two articles do not change things very much. I do believe that hormone therapy does increase the incidence of breast cancer. That, I feel, is the main reason why there are 100 cases of breast cancer in women to every 1 case in men.
Accepting the WHI numbers, 8 more woman per 10,000 get breast cancer if they take PremPro for one year. That's 0.08% per year. If a woman takes PremPro continuously from age 50 to age 65 (15 years), she increases her chance of getting breast cancer about 1%.
Another way to look at it is -- if a women does not take combination hormone therapy for those 15 years, her chance of getting breast cancer is about 4.5%. If she takes combination hormone therapy, it's about 5.5%. That's the price women pay for being the dominant sex. If you object to that 1% increased breast cancer risk over 15 years, you should not take hormones.
The question of straight estrogen versus combination estrogen-progestin remains a big unknown; but maybe in a few years we'll find out that the progestin is the primary culprit. It's looking more and more like that's the case.
For those of you who would like more details on this subject, you may click on the 4 links below:
That's all for now. The above is not meant to be medical advice. Please read the attached Disclaimer, Etc. If you know anyone who would like to receive "DrRehertsAlerts," send their Email address to grehert@...
Best wishes. Dr. Rehert
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