title: Estrogen replacement therapy in breast cancer survivors: a matched-controlled series.
abstract: OBJECTIVE
  We prospectively administered estrogen replacement therapy (ERT) to control estrogen deficiency symptoms in breast cancer survivors as part of our clinical practice. We report the consequences of ERT compared with a historical matched-control group.
  
  
  METHODS
  Two hundred seventy-seven disease-free survivors received ERT. Controls were matched for exact stage, a recurrence-free period similar to the period to ERT initiation in the ERT group, approximate age, and duration of follow-up. The mean time from breast cancer diagnosis to initiation of ERT was 3.61 (+/- 0.25) years, with a median of 1.88 years. The mean duration of ERT was 3.7 (+/- 3.01) years, with a median of 3.05 years.
  
  
  RESULTS
  Hot flashes were relieved in 206 of 223 women (92%), dyspareunia/vaginal dryness in 149 of 167 women (89%), and reactive depression/anxiety/mood change in 111 of 126 women (88%). Univariate analysis demonstrated no statistical differences between the groups for age, stage, pathology at diagnosis, progesterone receptor status, local therapy, breast at risk, prior chemotherapy, and duration of follow-up. The ERT group was more likely to be estrogen receptor negative (P = 0.01), to have received prior ERT (P < 0.001), and to have received no adjuvant tamoxifen (P < 0.001). There was no significant difference between the ERT and control groups in ipsilateral primary/recurrence (5/155 v 5/143; P = 0.85), contralateral breast cancers (10/258 v 9/260; P = 0.99), or systemic metastasis (8/277 v 15/277; P = 0.13). Noncause-specific deaths in the control group numbered 15 (of 277), and in the ERT group, 7 (of 277) (P = 0.03). Overall survival favored the ERT group (P = 0.02).
  
  
  CONCLUSIONS
  In these selected patients, ERT relieved estrogen deficiency symptoms and did not increase the rate or time to an ipsilateral recurrence/new primary, contralateral new primary, local-regional recurrence, or systemic metastases.
authors.affiliation: Department of Medicine, William Beaumont Hospital, Royal Oak-Troy, MI 48073, USA. ddecker@beaumont.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Decker
authors.forename: Jane E
authors.initials: JE
authors.lastname: Pettinga
authors.forename: Nancy
authors.initials: N
authors.lastname: VanderVelde
authors.forename: Raywin R
authors.initials: RR
authors.lastname: Huang
authors.forename: Larry
authors.initials: L
authors.lastname: Kestin
authors.forename: John H
authors.initials: JH
authors.lastname: Burdakin
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D016022:Case-Control Studies; D004414:Dyspareunia / Q000188:drug therapy; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000627:therapeutic use; D004970:Estrone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D019964:Mood Disorders / Q000188:drug therapy; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016019:Survival Analysis; D017741:Survivors; D014623:Vaginal Diseases / Q000188:drug therapy
chemical_list: D004967:Estrogens; D004970:Estrone; C009927:estropipate