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Is HRT justified for symptom management in women at higher risk of developing breast cancer?
Climacteric. 2006 Dec; 9(6):404-15.C

Abstract

Hormone replacement therapy (HRT) is the most efficacious intervention for the treatment of estrogen-deficiency symptoms. Prescriptions for HRT have fallen over the last 3 years due to anxiety provoked about breast cancer risk and recurrence that has been generated by recent clinical trials. In women at population risk of breast cancer, these trials have not shown risks greater than estimates from clinical trial evidence that predated them. For women at increased breast cancer risk due to a family history or high-risk benign breast conditions, clinical trial data are limited but suggest a lack of an additive effect of HRT on risk. In symptomatic breast cancer survivors, observational data suggest no increase in recurrence but these data are open to bias. Interim analyses of large, randomized trials have shown contradictory outcomes and, as a result, three large HRT randomized trials have now been closed. The randomized LIBERATE trial evaluating tibolone in breast cancer survivors is fully recruited and continuing. The current clinical climate is 'HRT adverse' but, due to a lack of effective alternatives for symptom relief, women at higher breast cancer risk and breast cancer survivors are still requesting information about HRT. In this situation, discussion of the current clinical uncertainty surrounding the use of HRT must be undertaken to ensure that women are adequately informed.

Authors+Show Affiliations

King's Breast Care, King's College Hospital NHS Trust, London, UK.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17085372

Citation

Rippy, L, and J Marsden. "Is HRT Justified for Symptom Management in Women at Higher Risk of Developing Breast Cancer?" Climacteric : the Journal of the International Menopause Society, vol. 9, no. 6, 2006, pp. 404-15.
Rippy L, Marsden J. Is HRT justified for symptom management in women at higher risk of developing breast cancer? Climacteric. 2006;9(6):404-15.
Rippy, L., & Marsden, J. (2006). Is HRT justified for symptom management in women at higher risk of developing breast cancer? Climacteric : the Journal of the International Menopause Society, 9(6), 404-15.
Rippy L, Marsden J. Is HRT Justified for Symptom Management in Women at Higher Risk of Developing Breast Cancer. Climacteric. 2006;9(6):404-15. PubMed PMID: 17085372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is HRT justified for symptom management in women at higher risk of developing breast cancer? AU - Rippy,L, AU - Marsden,J, PY - 2006/11/7/pubmed PY - 2007/7/17/medline PY - 2006/11/7/entrez SP - 404 EP - 15 JF - Climacteric : the journal of the International Menopause Society JO - Climacteric VL - 9 IS - 6 N2 - Hormone replacement therapy (HRT) is the most efficacious intervention for the treatment of estrogen-deficiency symptoms. Prescriptions for HRT have fallen over the last 3 years due to anxiety provoked about breast cancer risk and recurrence that has been generated by recent clinical trials. In women at population risk of breast cancer, these trials have not shown risks greater than estimates from clinical trial evidence that predated them. For women at increased breast cancer risk due to a family history or high-risk benign breast conditions, clinical trial data are limited but suggest a lack of an additive effect of HRT on risk. In symptomatic breast cancer survivors, observational data suggest no increase in recurrence but these data are open to bias. Interim analyses of large, randomized trials have shown contradictory outcomes and, as a result, three large HRT randomized trials have now been closed. The randomized LIBERATE trial evaluating tibolone in breast cancer survivors is fully recruited and continuing. The current clinical climate is 'HRT adverse' but, due to a lack of effective alternatives for symptom relief, women at higher breast cancer risk and breast cancer survivors are still requesting information about HRT. In this situation, discussion of the current clinical uncertainty surrounding the use of HRT must be undertaken to ensure that women are adequately informed. SN - 1369-7137 UR - https://www.unboundmedicine.com/medline/citation/17085372/Is_HRT_justified_for_symptom_management_in_women_at_higher_risk_of_developing_breast_cancer L2 - https://www.tandfonline.com/doi/full/10.1080/13697130601022367 DB - PRIME DP - Unbound Medicine ER -