Dr. N’s Guide to Menopause, Hysterectomy and Hormone Replacement Therapy

Does Hormone Replacement Therapy increase the risk of breast cancer?  

The belief that HRT increases the risk of breast cancer is without merit and is primarily based on misinformation contained in in an article commonly referred to as the Results of Estrogen plus Progestin Trial that appeared in The Journal of the American Medical Association in July of 2002. The article contained the statement that there was a substantial increase in the risk of breast cancer in the women taking the hormones in the Women’s Health Initiative sponsored trial.

Was there a substantial increase in the risk of breast cancer in the women using the hormones in the trial?

No there was not.

Dr. Jacque Rossouw who was the head the WHI and was in charge of the trial stated the trial provided no evidence that the hormones used in the study increased the risk of breast cancer. He went on to say that all the cancers found in the trial were present before the trial began. Dr. Rossouw told me this in a phone call in September of 2002 about two months following the publication. He confirmed this in another call I made about a month later and in subsequent face-to-face conversations.

Why did he say that?

He said as the length of  trial was only a little over five years during that short time a new breast cancer initiated by the hormones could not have grown to a size large enough to have been detected by either  mammography or a physician examination.

Then why did the article state that there was a substantial increase on the risk of breast cancer?

The text of the article was written by the Writing Group for the Woman’s Health Initiative Investigators. It is clear that the writing group misrepresented the study findings .What their agenda was remains unknown.

In an issue in the Journal Menopause Management, a colleague, James Simon, MD, clinical professor at George Washington University, President and Medical Director of Woman’s Health & Research Consultants, Washington, DC, and a Past president of the North American Menopause Society, wrote in a “Letter to the Editor:

“While I applaud those WHI investigators who are finally emerging to voice their concern and frustration with being excluded from the July 2002 media- grabbing media-distorting WHI publication, they now must find their own absolution and path to redemption.

An entire generation of women, their partners and their families suffer unnecessarily for their collective sins.”

Lisa is an attractive, delightful 54 year old woman tells her story: “Depressed no sex drive and no happiness.”

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