HEIDELBERG, Germany—Breast cancer patients who have received prior hormone-replacement therapy (HRT) have a significantly reduced risk of metastasis to bone, lung, and liver, according to a study reported by Ingo J. Diel, MD, of the Institute for Gynecological Oncology in Mannheim Germany. Dr. Diel was previously affiliated with the Department of Obstetrics and Gynecology at University Hospital in Heidelberg, Germany. The German study supports previous reports of improved outcome for breast cancer patients who have used HRT.
"We know very well that we have a moderate but significant increased risk for breast cancer in HRT users," Dr. Diel said. "But we know that for HRT and breast cancer mortality it is a different story. Several, but not all, studies on this topic show an improvement in overall survival in breast cancer patients with a history of preoperative HRT use. They conclude that there is reduced aggressiveness—by better grading of the tumor—slow-growing tumors, and smaller tumor size."
Most Were Postmenopausal
The Heidelberg group performed a retrospective study involving 1,160 patients who underwent breast cancer surgery at University Hospital between 1990 and 2000. The age range was 45 to 70. Most of the women were postmenopausal—847 compared to 313 women who were premenopausal.
Patients designated as HRT users had taken hormones for at least 1 year prior to diagnosis (mean, 60 months). In the study population, 343 patients were considered to be HRT users, and 504 patients were designated as nonusers. Among the HRT users, 63.8% had used cyclic estrogen and progesterone(Drug information on progesterone).
The investigators’ analyses confirmed previous findings that HRT users have an advantage in terms of tumor size and tumor grade. Moreover, the group of patients who had not taken HRT had the highest death rates, and mortality was greatly reduced in the postmenopausal HRT users. No significant differences were found between HRT users and nonusers in terms of nodal status, hormone receptor status, and S-phase fraction.
Completely New Finding
