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More Node+ Breast Cancer, Higher Mortality After HRT

Data from 11 year follow-up confirm higher breast cancer incidence in HRT group

TUESDAY, Oct. 19 (HealthDay News) -- Postmenopausal estrogen-plus-progestin therapy not only results in an increased incidence of invasive breast cancers but also in more node-positive cancers and an increased mortality rate, according to an analysis published in the Oct. 20 issue of the Journal of the American Medical Association.

Rowan T. Chlebowski, M.D., of the Harbor-UCLA Medical Center in Torrance, Calif., and colleagues followed 12,788 surviving participants of the Women's Health Initiative to determine the effects of estrogen plus progestin on cumulative breast cancer incidence and mortality after a mean follow-up of 11 years.

The researchers found that women in the estrogen-plus-progestin group had a 25 percent greater risk of invasive breast cancer than women in the placebo group (0.42 versus 0.34 percent per year). Breast cancers in the estrogen-plus-progestin group were significantly more likely to be node positive (hazard ratio [HR], 1.78). Women who received estrogen plus progestin had higher breast cancer-related mortality (HR, 1.96) and higher all-cause mortality (HR, 1.57) than women in the placebo group.

"Given the substantial population of women who seek relief from menopausal symptoms and the large potential burden of disease that could be created if medications given to alleviate symptoms today cause cancer and other deaths tomorrow, it seems that additional randomized trials are needed specifically to determine whether lower doses or shorter durations of hormone therapy could alleviate menopausal symptoms without increasing cancer risk," write the authors of an accompanying editorial.

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