Hormone replacement therapy after cancers.
OBJECTIVE
The role of female hormones in estrogen-dependent cancers has been debated for years. This is particularly true of breast cancer. Retrospective, case, and cohort control studies usually have suggested no influence. The Women's Health Initiative study in 2002, a prospective double-blind study, noted an increased risk of breast cancer if estrogen plus progesterone was given. In the estrogen-only arm of that study, a decreased (not significant) risk of breast cancer was noted. With this controversy, can estrogen be given safely to a woman who has been treated for breast cancer? The relation between endometrial cancer and unopposed estrogen is well established. With clear-cut evidence of this relation, is there evidence to suggest a role for replacement therapy in women who have been treated for endometrial cancer?


RESULTS
Several case-control and cohort studies have noted either no increased risk or actually less risk of recurrence in women taking estrogen after therapy after breast cancer. Although the general consensus is that such a recommendation is contraindicated, the data do not support this admonition. The current data suggest that replacement therapy can be given to the woman who has been treated for endometrial cancer.


CONCLUSIONS
There seems to be little if any risk in giving hormone replacement therapy to women who have had breast or endometrial cancer. There are no data to suggest that hormone replacement therapy is contraindicated in women who have been treated for cervical or ovarian cancer.
Creasman
William T
WT
Department of Obstetrics and Gynecology, Medical University of South Carolina, 96 Jonathan Lucas Street, PO Box 250619, Charleston, SC 29425, USA. creasman@musc.edu
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000188:drug therapy; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D000075202:Contraindications; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000188:drug therapy; D004967:Estrogens / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D010051:Ovarian Neoplasms / Q000139:chemically induced* / Q000188:drug therapy
D018931:Antineoplastic Agents, Hormonal; D004967:Estrogens