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Estrogen-replacement therapy in younger women with breast cancer.
J Natl Cancer Inst Monogr 1994; (16):149-52JN

Abstract

Approximately 25% of breast cancers occur in premenopausal women. In addition to local therapy, surgery or surgery plus irradiation, systemic chemotherapy administration has become the standard of care for all node-positive and many node-negative patients. Systemic adjuvant chemotherapy can result in ovarian dysfunction or failure. This renders many women prematurely estrogen deficient. The consequences of menopause, genitourinary atrophy, bone loss, and increased risk of cardiovascular disease, have not been routinely assessed in clinical trials. The risks of estrogen deficiency have not been assessed in comparison to improved disease-free and overall survival benefits of adjuvantly treated premenopausal breast cancer patients. Estrogen-replacement therapy in postmenopausal women has been shown to prevent osteoporosis and reduce fracture risk. The majority of studies also show a marked reduction in cardiovascular disease and mortality. Estrogen-replacement therapy has been considered a disease-prevention strategy rather than a therapeutic intervention. The risks and benefits of estrogen-replacement therapy in women with primary breast cancer are unknown. It is unknown how the well-known benefits accrued from reduction in skeletal and cardiovascular morbidity/mortality compare with the potential risks of increased breast cancer morbidity/mortality. Carefully designed prospective clinical trials with well-defined objectives and endpoints are required to learn if more harm than good is done by the withholding of estrogen therapy in breast cancer patients.

Authors+Show Affiliations

Department of Breast and Gynecological Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

7999457

Citation

Theriault, R L., and R V. Sellin. "Estrogen-replacement Therapy in Younger Women With Breast Cancer." Journal of the National Cancer Institute. Monographs, 1994, pp. 149-52.
Theriault RL, Sellin RV. Estrogen-replacement therapy in younger women with breast cancer. J Natl Cancer Inst Monographs. 1994.
Theriault, R. L., & Sellin, R. V. (1994). Estrogen-replacement therapy in younger women with breast cancer. Journal of the National Cancer Institute. Monographs, (16), pp. 149-52.
Theriault RL, Sellin RV. Estrogen-replacement Therapy in Younger Women With Breast Cancer. J Natl Cancer Inst Monographs. 1994;(16)149-52. PubMed PMID: 7999457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estrogen-replacement therapy in younger women with breast cancer. AU - Theriault,R L, AU - Sellin,R V, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 149 EP - 52 JF - Journal of the National Cancer Institute. Monographs JO - J. Natl. Cancer Inst. Monographs IS - 16 N2 - Approximately 25% of breast cancers occur in premenopausal women. In addition to local therapy, surgery or surgery plus irradiation, systemic chemotherapy administration has become the standard of care for all node-positive and many node-negative patients. Systemic adjuvant chemotherapy can result in ovarian dysfunction or failure. This renders many women prematurely estrogen deficient. The consequences of menopause, genitourinary atrophy, bone loss, and increased risk of cardiovascular disease, have not been routinely assessed in clinical trials. The risks of estrogen deficiency have not been assessed in comparison to improved disease-free and overall survival benefits of adjuvantly treated premenopausal breast cancer patients. Estrogen-replacement therapy in postmenopausal women has been shown to prevent osteoporosis and reduce fracture risk. The majority of studies also show a marked reduction in cardiovascular disease and mortality. Estrogen-replacement therapy has been considered a disease-prevention strategy rather than a therapeutic intervention. The risks and benefits of estrogen-replacement therapy in women with primary breast cancer are unknown. It is unknown how the well-known benefits accrued from reduction in skeletal and cardiovascular morbidity/mortality compare with the potential risks of increased breast cancer morbidity/mortality. Carefully designed prospective clinical trials with well-defined objectives and endpoints are required to learn if more harm than good is done by the withholding of estrogen therapy in breast cancer patients. SN - 1052-6773 UR - https://www.unboundmedicine.com/medline/citation/7999457/Estrogen_replacement_therapy_in_younger_women_with_breast_cancer_ L2 - http://www.diseaseinfosearch.org/result/960 DB - PRIME DP - Unbound Medicine ER -