Menopausal Hormone Therapy Influence on Breast Cancer Outcomes in the Women's Health Initiative

Authors:
Rowan T. Chlebowski From Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, and Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, Washington.

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 MD, PhD
,
Aaron K. Aragaki From Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, and Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, Washington.

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 MS
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Garnet L. Anderson From Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, and Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, Washington.

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 PhD
Volume/Issue:
Volume 13: Issue 7
Online Publication Date:
Jul 2015
DOI:
https://doi.org/10.6004/jnccn.2015.0106
Restricted access

The Woman's Health Initiative has conducted 2 full-scale, placebo-controlled clinical trials to determine the influence of menopausal therapy on breast cancer incidence and outcome. Estrogen plus progestin use in postmenopausal women with a uterus increases breast cancer incidence and deaths from breast cancer. Despite a short-term reduction in risk after stopping estrogen plus progestin use, an increase in breast cancer risk persists postintervention. Estrogen-alone use in postmenopausal women with prior hysterectomy reduces breast cancer incidence and reduces deaths from breast cancer. The reduced breast cancer risk persists for several years after stopping estrogen-alone use but is lost in late postintervention. These findings suggest recalibration of breast cancer risk and benefit consideration for both regimens, with estrogen plus progestin use associated with greater risk and estrogen-alone use associated with greater benefit. Use of either regimen in clinical practice requires careful consideration of all clinical risks and benefits.

Correspondence: Rowan T. Chlebowski, MD, PhD, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1024 West Carson Street, Building J-3, Torrance, CA 90501. E-mail: rowanchlebowski@gmail.com
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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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Copyright:
Copyright © 2015 by the National Comprehensive Cancer Network 2015
Page Numbers:
8
Article Category:
Review Article
Received:
08 Mar 2015
Accepted:
26 May 2015
Print Publication Date:
01 Jul 2015
Online Publication Date:
Jul 2015

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