Estrogen replacement therapy (ERT) in high-risk cancer patients.
Menopausal estrogens are now being prescribed not only for symptom relief, but also to prevent the long-term sequelae of estrogen deficiency, namely osteoporosis and atherosclerotic disease. The well-established association between endometrial cancer and estrogen replacement therapy (ERT) has become less of a clinical concern due to the recognition of the protective effect of progestogens in this setting. A small literature has emerged suggesting that extending ERT to the woman with a history of endometrial carcinoma imposes no increased risk of recurrence and may improve survival. Candidates for ERT should be women with a better prognostic profile with reference to their cancer. The relationship between ERT and breast cancer remains a topic of intense debate and investigation. Overall, the current literature finds no significant increase in risk among healthy women without a family history of breast cancer. There are no guidelines with reference to the woman with a history of breast cancer and the use of ERT. The most prudent approach with this population is to consider alternative treatments until more is known.
Hutchinson-Williams
K A
KA
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
Gutmann
J N
JN
D001943:Breast Neoplasms / Q000503:physiopathology*; D003276:Contraceptives, Oral / Q000009:adverse effects; D000075202:Contraindications; D004702:Endocrine Glands / Q000502:physiology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects / Q000502:physiology; D011247:Pregnancy / Q000502:physiology; D012008:Recurrence; D012307:Risk Factors; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000139:chemically induced / Q000401:mortality / Q000503:physiopathology*
D003276:Contraceptives, Oral