Eleven Years Tracking the WHI (Women's Health Initiative = Study of Women's Health Initiative) suggest that combined hormone therapy increases the risk for Advanced Breast Cancer, Incidence and Mortality in
October 27, 2010
Eleven Year Follow-up of the WHI (Women's Health Initiative = Study of Women's Health Initiative) suggest that combined hormone therapy increases the risk for Advanced Breast Cancer, Incidence and Mortality in Jaime
Urdinola MD Medical Association AK9 Andes-Bogotá 326-11620 CS-Phone DCColombia 00 571 / 21523 e-mail: jaimeurdinolamd@gmail.com- blogger: http://www.urdinola.blogspot.com www.urdinolamenopausia2.blogspot.com Symposium / Luncheon on Women's Health and Menopause Medical Association Andes - Board Room - First Floor - Wednesday, October 27, 2010
A new analysis of data from the Women's Health Initiative (WHI = Initiative of Women's Health) published a few days in JAMA, suggests that women who take estrogen and progesterone have more advanced cases of breast cancer and a mortality rate slightly higher than those women not taking this hormone combination.
The report is based on an analysis of data related to monitoring for 11 years in 12 788 women participating in the WHI study who gave their consent to continue after the initial 5.6 years, from a total at the beginning of recruited 16 608 postmenopausal women. As previously shown the report, the rate of disease among women taking the hormone combination was 0.42% per year, compared with 0.34% per year among women in the placebo group. However, recent analysis shows that among women who have developed cancer de seno, 23.7 % de las mujeres en tratamiento con la terapia hormonal presentaban nódulos linfáticos, un signo de enfermedad más avanzada, comparado con 16.2 % entre las mujeres recibiendo placebo, p= 0.03.
Adicionalmente, se observaron aprox. 2.6 muertes por 10 000 mujeres por año en las mujeres que tomaron la terapia hormonal, comparadas con una tasa de 1.3 muertes por 10 000 mujeres por año en el grupo que tomó placebo, p= 0.049. Las mujeres que tomaron la terapia hormonal presentaron una tasa más alta de muerte por todas las causas de 5.1 muertes, en comparación con 3.1 muertes por 10 000 mujeres por año en el grupo placebo, p= 0.045. Esto significa 2 muertes extra en las usuarias de hormonas.
prevalent previously thought, based on some publications until 2 years ago, it was cancer that occurs in women who took hormone therapy might be more favorable and not be a problem. But what is clear from the current publication, is that breast cancer associated with hormone therapy is linked to higher risk of death. May therefore be considered very seriously and critically, if the need for hormone therapy in menopausal women exists and is fully justified its use.
editorial in the same volume of this journal, Peter Bach suggests that researchers underestimate the increase in deaths from breast cancer due to hormone therapy, because as you follow up longer term, the deleterious effect of hormone therapy appears as a major. Bach also questioned the current form to advise women on hormone therapy in relation to the lowest dose and shortest time possible, because in reality there is a gap on this and do not really know the risks of hormone therapy led to this form.
Another of the authors of this study, JoAnn E. Manson said women should not take hormone therapy, unless really necessary, to treat moderate to severe symptoms such as hot flashes night sweats and interrupted sleep, thus seriously affecting the quality of life.
In his view this new information should not necessarily frighten women under hormone treatment, as this report found only 2 cases of breast cancer death per 10 000 women per year in women treated. The data suggest that this is cumulative with the long-term use, so women should not use hormone therapy for a long time. References
- Rowan T. Chlebowski, MD, PhD, Garnet L. Anderson, PhD, Margery Gass, MD, Dorothy S. Lane, MD, Aaron K. Aragaki, MS, Lewis H. Kuller, MD, JoAnn E. Manson, MD, DrPH, Marcia L. Stefanick, PhD, Judith Ockene, MD, Gloria E. Sarto, MD, Karen C. Johnson, MD, MPH, Jean Wactawski-Wende, PhD, Peter M. Ravdin, MD, PhD, Robert Schenken, MD, Susan L. Hendrix, DO; Aleksandar Rajkovic, MD, PhD, Thomas E. Rohan, PhD, Shagufta Yasmeen, MD, Ross L. Prentice, PhD, for the WHI Investigators. Estrogen Plus Progestin and Breast Cancer Incidence and Mortality in Postmenopausal Women. JAMA. 2010, 304 (15) :1684-1692. doi: 10.1001/jama.2010.1500
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