Estrogen-Progestin Therapy Elevates Risk for Breast Cancer — Should This Influence Clinical Practice?

No; benefits will outweigh risks for many menopausal patients who, through discussion of research findings and shared decision making, can make informed choices about HT use.

Hormone therapy (HT) is the most effective treatment for bothersome menopausal vasomotor symptoms. However, after initial publication of findings from the Women's Health Initiative (WHI) randomized clinical trial in 2002, which found that estrogen-progestin therapy (EPT) increased risk for cardiovascular events and breast cancer among women aged 50 to 79 at enrollment (NEJM Journal Watch Womens Health Nov 2013 and JAMA 2013 Oct 2; 310:1353), use of HT plummeted in the U.S. and globally. Subsequently, the estrogen-alone trial in women with hysterectomy showed that conjugated estrogens (for a median of 7 years) did not increase breast cancer risk. Both regimens raised risk for stroke and venous thromboembolism but lowered risk for fractures a…

Authors

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

JoAnn E. Manson, MD, DrPH

Estrogen-Progestin Therapy Elevates Risk for Breast Cancer — Should This Influence Clinical Practice?

Topics

Authors