HORMONE
REPLACEMENT THERAPY (HRT) AND BREAST CANCER – IMPORTANT NEW INFORMATION
You
may have seen in the news that a large study in the UK, the Million Women
Study, has just published its results on the risk of breast cancer with
various types of HRT. This study shows that the level of risk associated with
use of combined (oestrogen plus progestogen) HRT products is substantially
higher than previously thought. If, after reading the information below, you
are concerned, make a routine appointment to see your doctor.
Use
of HRT
In
the UK, HRT products are licensed for helping relieve the unpleasant symptoms
of the menopause, including hot
flushes, vaginal dryness and night sweats. Some HRT products are also licensed
for the longer-term prevention of osteoporosis, which can cause
bone fractures.
Million
Women Study findings
This
study looked at the effect of different types of HRT on the risk of breast
cancer in nearly a million postmenopausal women in the UK. The results confirm
that oestrogen-only HRT causes a small increase in the risk of breast cancer.
Combined (oestrogen plus progestogen) HRT products were shown to increase the
risk of breast cancer more than oestrogen-only therapy.
Ø
For oestrogen only products, an extra 1-2 cases of breast
cancer are expected to be diagnosed per 1000 women after 5 years of use
and an extra 5 cases per 1000 women after 10 years of use, compared to
women not using HRT.
Ø
For combined HRT an extra 6 cases of breast cancer are
expected to be diagnosed per 1000 women after 5 years of using combined
HRT and an extra 19 cases per 1000 women after 10 years, compared to
women not using HRT.
Ø
This study also shows that the use of tibolone (Livial - a different
type of HRT product) increases the risk of breast cancer compared to not using
HRT. However, the risk is not as high as with combined HRT.
Ø
The longer HRT is used, the higher the risk of breast cancer.
Ø
In
all cases, the risk of breast cancer begins to decline when HRT is stopped and
by 5 years reaches the same level as in women who have never taken HRT.
Take
home message
This
new study confirms what we already knew about the risk of breast cancer with
oestrogen-only preparations and provides important new information about the
risk with combined HRT and tibolone. If you are concerned about this
information, make a routine appointment to see your doctor. These new
results may present you and your doctor with a dilemma about your HRT
treatment. It is important that you note any changes with your breasts and, if
you are 50 or over, attend for breast screening (for further information see
www.cancerscreening.nhs.uk/breastscreen/breastawareness.
html).
Further
information
Further
information and advice may be found on the Medicines and Healthcare products
Regulatory Agency’s website (www.mhra.gov.uk). Here you can find more
details about the other risks and benefits of HRT treatment, which may help to
answer some of the questions you may have about these new findings. NHS Direct
may also be able to answer your questions (Tel 0845
4647).
