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Study: Hormonal Menopause Therapy associated with Breast Tumors 

In a five-year therapy, usual today, half of the extra risk is recorded during that same period, but the other half is distributed during the 15 years following the cessation of hormone administration.

An analysis of more than 100,000 women shows that daily estrogen and progestin treatment for five years is linked to one more case of the tumor for every 50 users

The largest study to date has confirmed that menopausal hormone therapy is associated with an increased risk of invasive breast cancer.

Some 6.3% of women who have never resorted to this treatment develop one of these tumors between the ages of 50 and 69, compared with 8.3% of those who undergo a combined estrogen and progestin therapy for five years daily, according to the new work, led by researchers from the University of Oxford.

The absolute increase in risk, of 2 percentage points, is one more case of cancer for every 50 users of the treatment.

The authors, led by the epidemiologist Valerie Beral, have analyzed the data of almost 110,000 women with invasive breast cancer after menopause, diagnosed with an average age of 65 years.

For many women, hormone replacement therapy is recommended to relieve common symptoms of menopause, a time when reduced production of estrogen and progesterone in the ovaries can cause a decrease in bone mass, insomnia and sudden overheating.

Treatment consists of the prescription of estrogen alone – usually for women whose uterus has been removed – or with progestin, a synthetic hormone whose effects are similar to those of progesterone.

Currently, about six million Europeans receive this therapy, usually in tablets.

Beral’s team has calculated the risk according to the type of treatment. 6.8% of women who only received estrogen developed invasive breast cancer, an increase of one case per 200 users.

In estrogen therapy with intermittent progestin, the percentage reached 7.7%: an extra case for every 70 women.

The study, published in the medical journal The Lancet, emphasizes that the risk depends on the duration of the treatment.

In a five-year therapy, usual today, half of the extra risk is recorded during that same period, but the other half is distributed during the 15 years following the cessation of hormone administration.

In 10-year therapies, common in the past, the relative risk, which remains low, doubles. In treatments of one year or administered with estrogen creams and vaginal suppositories there is hardly an increase in cancer risk.

European health authorities have recommended for years that hormonal therapy last as short as possible and with the lowest effective dose.

In 2002 and 2004, two clinical trials funded by the US National Institutes of Health have already shown that combined estrogen and progestin therapy increased the risk of cancer, but observed no effects on estrogen treatment alone.

“Our new results indicate that the increased risk of cancer caused by the administration of hormones persists even after the end of therapy. The previous estimates of the risks are doubled if this persistent risk is taken into account after the end of the treatment,” Beral explained in a statement.

In an independent comment published in The Lancet, oncologist Joanne Kotsopoulos calls for putting the new data in context.

“Perhaps the concern about breast cancer has deprived millions of women of an effective remedy for some of the symptoms of menopause. It is important to know the real risk of cancer if women are suffering the consequences of avoiding hormonal therapy for menopause and possibly increasing their risk of osteoporosis, cognitive impairment and other cardiovascular health problems,” says Kotsopoulos of the University of Toronto in Canada.

Doctors should pay attention to the message of this study, but they should also adopt a rational and comprehensive approach to the treatment of menopausal symptoms, with a careful assessment of the risks and benefits of starting therapy for each woman.

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About the author: Luis R. Miranda

Luis R. Miranda is an award-winning journalist and the founder & editor of The Real Agenda News. His career spans over 23 years in every form of news media. He writes about environmentalism, education, technology, science, health, immigration and other current affairs. Luis has worked as on-air talent, news reporter, television producer, and news writer.

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