Editorials represent the opinions EDITORIAL of the authors and JAMA and not those of the American Medical Association. Postmenopausal Hormone Therapy and Breast Cancer An Uncertain Trade-off (FDA) allows the manufacturer to claim is reduction of risk Peter B. Bach, MD, MAPP of osteoporotic fractures. That breast cancer rates in the WHI increased among N 2002, THE WOMEN’S HEALTH INITIATIVE (WHI) RAN- women receiving hormone therapy was not surprising. Epi- domized trial of placebo vs hormone therapy with es- 5 demiological and biological studies had anticipated the effect, trogen and progestin was stopped early because of evi- although the magnitude of risk was not known until the WHI, Idence of harm. Sales of combined estrogen-progestin which showed that the effect of hormone therapy on breast plummeted 32% between the period immediately before the cancer risk was about the same as the deleterious effect on study’s release and the analogous period 1 year later, as the cardiovascular health. In each case, 42 more of approxi- WHI trial had shown that hormone therapy increased a wom- mately 8000 women in the hormone therapy group than the an’s risk of breast cancer and myocardial infarction. The placebo group experienced the adverse outcome.
JAMA – American Medical Association
Published: Oct 20, 2010