CONTACT: Kristi Hellmuth
Johanna Spangenberg
(202) 638-7222
NEWS ROOM: March 20-26, 1997
Pointe Hilton
on South Mountain
Phoenix, AZ
(602) 431-6501
NEW MEDICAL RESEARCH REVEALS THAT ESTROGEN REPLACEMENT THERAPY MAY BE SAFE FOR BREAST CANCER SURVIVORS
Retrospective Analysis of 145 Breast Cancer Survivors from Across the Nation Finds Beneficial Hormone Replacement Therapy Does Not Activate Tumor Growth
PHOENIX, AZ (March 26, 1997) -- Women who have survived breast cancer may be treated with hormone replacement therapy without significant risk of the hormone re-activating malignant tumors. This is the finding of five gynecologic oncologists, each from a prestigious medical center, who reviewed the medical records and follow up data of 145 women who survived breast cancer and underwent hormone replacement therapy (HRT).
Authors of the retrospective analysis are gynecologic oncologists W.R. Brewster, MD, and P.J. DiSaia, MD, of the University of California-Irvine Medical Center; E.A. Grosen, MD, of the University of Wisconsin-Madison; K.F. Mogonigle, MD, of the City of Hope National Medical Center, Duarte, CA; and W.T. Creasmen, MD, of the Medical Center of South Carolina.
Patients in this analysis had been seen at the University of California-Irvine Medical Center, and the Medical Center of South Carolina.
The results of this study were considered presented at the 28th Annual Meeting of the Society of Gynecologic Oncologists, at the Pointe Hilton on South Mountain, Phoenix, AZ. In addition to gynecologic oncologists, the organization's 800 members include medical oncologists, radiation therapists, and pathologists whose primary professional commitment is to the treatment of women with gynecologic malignancies, including cancers of the ovary, endometrium, uterus, cervix, vagina, and vulva, as well as trophoblastic disease.
Background
Estimates are that at least 30 million women in the United States will spend at least 40% of their lives in the menopausal period. After two decades of research, there is growing evidence that postmenopausal hormone replacement protects women against osteoporosis, heart disease, "hot flashes," colon cancer, and even Alzheimers disease.
HRT should be for 11% of women who will develop breast cancer and premenopausal women who undergo chemotherapy for breast cancer. (Studies show a majority of premenopausal women are rendered menopausal by the effects of chemotherapy on ovarian tissue). Consequently, breast cancer creates a substantial pool of estrogen impoverished women who would seem to be natural candidates for the hormonal replacement therapy.
However controversy exists to this day regarding the increased risk of breast cancer associated estrogen replacement therapy. Even without conclusive evidence, many physicians still discourage breast , cancer survivors from using this form of treatment.
The Study
The five authors believed that this standard of medical practice deserved a long, overdue reappraisal. From January 1985 through December 1996, 145 women who had survived breast cancer and elected hormone replacement therapy were identified. The patients were from the authors' home medical institutions; all were advised of the benefits and theoretical risks regarding this treatment. Additionally, each patient understood that that the study authors did not believe there was solid evidence that HRT would affect their disease process nor prevent a recurrence of the cancer.
Hormonal replacement therapy was provided to all patients regardless of the time interval since diagnosis, estrogen or progesterone receptor status, stage, histology, or age. HRT was provided to all post-menopausal patients. The preferred regimen consisted of conjugated hormone replacement 0.625 mg/d and medroxyprogesterone acetate 2.5 mg/d. Patients unable to tolerate low hormonal doses and without a uterus were given only the conjugated estrogen.
Results
The patient follow up and outcome were retrospectively analyzed. One hundred and twenty-nine of the patients are still alive without any evidence of recurrent cancer. Thirteen recurrences of
breast cancer were observed. Three patients succumbed to disease not related to breast cancer, two died of advanced stage ovarian carcinoma, and one of endometrial cancer. The study's five gynecologic oncologists recommend that physicians inform patients who have survived breast cancer about the risks and benefits of HRT to help them make a rational therapeutic decision on an individual basis.
Comment
According to Dr. Brewster, a lead author of the study, "It is important to note that many breast cancer patients die from diseases other than breast cancer, such as heart disease and osteoporosis. That's why we offer HRT to our patients." Accordingly, the authors believe that their study's results should cast doubt on the prevailing theory that estrogen replacement therapy leads to a recurrence of breast cancer.
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The authors of this study are available to talk to the media regarding their study objectives, methodology, and results. Contact Kristi Hellmuth or Johanna Spangenberg at (202) 638-7222 for more information about this research or an interview with the authors.
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