SAN DIEGOHormone replacement therapy (HRT) did not
shorten survival in women who received it after surviving breast
cancer, Wendy R. Brewster, MD, reported in a plenary presentation at
the 31st annual meeting of the Society of Gynecologic Oncologists
This study did not permit control of other prognostic breast
cancer survival factors such as estrogen-receptor status or other
comorbid conditions. However, this analysis does not suggest that
hormone replacement therapy after treatment of breast cancer is
associated with an adverse outcome, said Dr. Brewster, of the
University of California, Irvine.
In fact, the researchers found that breast cancer survivors who
received HRT had a significant survival advantage, compared with
their matched controls (P = .003). The odds ratio for risk of death
was 0.28 (95% CI: 0.11 to 0.71) for the HRT group, compared with
controls. This finding is somewhat surprising in view of the
established role of estrogen in promotion of some types of breast cancer.
Overall survival from all causes is impacted by HRT, Dr.
Brewster told ONI in an interview. Patients should not be
categorically denied HRT. Instead, the risks and benefits must be
weighed and discussed in each case.
This retrospective study included a cohort of 125 women who had
received HRT after a diagnosis of breast cancer. The investigators
identified 362 matched control subjects from a regional cancer
registry. Controls were eligible if they were alive at the time HRT
was initiated in the case patient and if they had not received HRT.
Matching criteria included age at diagnosis, stage of breast cancer,
and year of diagnosis. The mean age of cases was 51.9 years.
Ninety percent of the cases (123 women) received systemic estrogen,
and 72% (90 women) received a progestational agent. The median
interval between breast cancer diagnosis and beginning of HRT was 46
months, and mean duration of HRT was 22 months.
More Endometrial Cancers
There were more endometrial cancers in the HRT group than in the
controls (6 vs 0). Dr. Brewster said that the statistical
significance of this difference in endometrial cancer occurrence in
breast cancer survivors was not calculated.
Senior investigator for the study was Philip J. DiSaia, MD, who also
reported data on the use of estrogen replacement after treatment for