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Decline in HRT Use Linked to Drop in Breast Cancer


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"While there have been a number of theories put forward to explain the increase, it now looks like some of that increase is due to the use of HRT," Berry said. "When women stopped using HRT, it looked kind of like a market correction and the numbers went back down."

Initially, it appeared as if combination estrogen-progestin hormone replacement therapy was the answer to many ills. Researchers hoped that HRT would lower the risk of such serious illnesses as heart disease and dementia.

However, the WHI study, which included more than 16,000 postmenopausal women, was stopped early in May 2002 because HRT was increasing the risk of coronary disease, stroke and blood clots.

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After the WHI trial was halted, many women stopped taking hormones. In fact, the use of HRT had dropped by 38 percent in the United States by the end of 2002. In 2001, 61 million prescriptions were written for hormone replacement therapy. In 2002, there were about 47 million prescriptions. By 2003, that number had fallen to 27 million, and by 2004 just 21 million, the study authors noted.

The rate of breast cancer started dropping soon after the WHI results in 2002, according to the new study.

Between 2001 -- the last full year of combination HRT use -- and 2004, rates of breast cancer in the United States dropped by 8.6 percent in postmenopausal women. The rates of estrogen receptor-positive breast cancer -- those cancers known to be fueled by the hormone estrogen -- dropped by 14.7 percent in women between the ages of 50 and 69. Yet, rates of estrogen receptor-negative cancers dropped only 1.7 percent in the same time period, which further suggests that stopping HRT played a role in the decline.

"HRT is probably not something that causes cancer; it probably just fuels existing cancers," explained Berry. "If you feed it, it grows, and if you stop feeding it, it stops growing."

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Copyright © 2007 ScoutNews, LLC. All rights reserved.
Last updated 4/19/2007

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SOURCES: Donald Berry, Ph.D., chairman, department of biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston; Julia Smith, M.D., Ph.D., director, New York University Cancer Institute Breast Cancer Screening and Prevention Program, and director, Lynne Cohen Breast Cancer Preventive Care Program, New York University Cancer Institute and Bellevue Hospital, New York City; April 19, 2007, New England Journal of Medicine; April 19, 2007, online The Lancet


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