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Eden John A.; Bush, Trudy; Nand, Swaran; Wren, Barry G.
Menopause: 1995
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Our objective was to examine the effect on all-cause mortality and tumor recurrence rate of combined continuous estrogen-progestin therapy given to symptomatic menopausal women with a personal history of breast cancer. We performed a nested case-control study in a cohort of women with a personal history of breast cancer. The entire database comprised 901 women with surgically confirmed breast cancer attending one of three teaching hospitals in south-eastern Sydney, Australia. Ninety had taken estrogen for relief of severe menopausal symptoms after their diagnosis and treatment of breast cancer. Most were using combined continuous estrogen-progestin therapy, usually an oral estrogen with a moderate dosage progestin. Controls were matched subjects from the same database who had not taken sex steroids after their diagnosis of cancer. The main outcome measures were all-cause mortality and recurrence of breast cancer (or new contralateral breast cancer). Relative risks (RR) were then calculated comparing sex-hormone users with matched controls. Among the 90 estrogen users, there were no deaths and only 7% developed a recurrence, compared to 17% of the nonusers (using two matched controls); RR = 0.40 (95% CI 0.17–0.93). These results suggest that short-term usage of combined continuous hormone replacement therapy (HRT) by women with a personal history of breast cancer may be safe and might even reduce the risk of recurrence. A formal prospective double-blind controlled study is needed to confirm these results.

©1995The North American Menopause Society