Hormone Therapy Raises Odds of Breast Biopsy
Though hormone replacement therapy works well to alleviate menopausal symptoms, that relief comes at a price in the form of a slightly elevated risk of breast cancer. Well, now the price just got a bit steeper. A study out today in the Archives of Internal Medicine shows that HRT boosts the likelihood of having an abnormal mammogram or a breast biopsy.
Let's look at the numbers: In the study, some 35 percent of HRT users had an abnormal mammogram compared with 23 percent of those taking placebos, and 10 percent had biopsies based on their mammograms compared with 6 percent of those on placebos. Adding insult to injury, more breast cancers were diagnosed in the hormone takers even though mammograms were also more likely to miss tumors in this group. (The researchers used data from the Women's Health Initiative trial, which randomly assigned more than 16,000 women to get either HRT or a placebo.) The effects last for at least a year after women go off hormones.
"I think this finding could influence women considering hormone therapy," says study author Rowan Chlebowski, a medical oncologist at the Los Angeles Biomedical Research Institute. After all, no woman wants to have a breast cancer scare, and biopsies themselves can cause tissue damage that in rare cases can lead to malignancies. One possible explanation for the missed cancers is that hormones increase the density of breast tissue, thus masking tumors, which are also dense; an increase in density can also create a friendly environment for cancer cells to grow.
What about opting for other imaging tests? Digital mammograms tend to be more accurate in women with dense breasts, and magnetic resonance imaging might have benefits in high-risk women, but the research article says that whether these can improve the diagnostic performance of imaging in HRT users "remains to be determined." In other words, the studies are lacking.
Should you instead try those "natural" bioidentical hormones to combat hot flashes, sleeplessness, and mood swings? They're certainly hot right now. Amazon has seven books for sale on these products (including one written by former TV star Suzanne Somers), generally touting these pills as safer and more effective than traditional HRT. Chlebowski, though, points out that the devil you know is probably better than the devil you don't. "I don't think there's any reason to think they'd behave differently in the breast than synthetic hormones," he tells me, "and we don't even have data on whether they're safe." The Food and Drug Administration agrees. Last month, the agency sent seven letters to companies selling "BHRT," warning them that claims made on the products are unsupported by medical evidence and are considered false and misleading. Some of the manufacturers claim that BHRT is identical to hormones made by the body and can stave off Alzheimer's, stroke, and cancer.
The bottom line is that women with severe menopause symptoms might still be better off spending a few years on HRT than suffering through the transition without it. Those with mild discomfort, however, should weigh the new finding into their decision. Above all, women older than 50 should continue to get yearly mammograms regardless of whether they take HRT. The screening tool, though far from perfect, reduces the risk of dying of breast cancer by up to 30 percent.
Tags: breast cancer | cancer
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Reader Comments
No Mammogram for ME!
EVER!
When 50 years after the chemical revolution that gave us plastics that leach xenoestrogens into our bodies, the drug 'revolution' that gave us the convenience of not having to keep our dimpled knees shut, and now the HRT therapy that keeps us from dealing with the discomforts of life - when all this totals up to the nearly tripling of breast cancer rates over that same period of time - from one in 20 (5%) to nearly one in 7 (or three out of 21 - 13% or so), you know it's been a bang up job for the drug and cancer industry to make a tidy profit for itself.
Sell poison to women, giving them the notion of 'no consequences' (unwanted babies) and wait a few decades and watch the profits roll in.
I am a 43 year old woman who NEVER has taken birth control. I rightly sussed out that these poisonous chemicals (estriadol IS A CARCINOGEN - no matter HOW you try to play it down! HELLO!!!) represent no answer to any problem that cannot be solved by using a bit of personal responsibility..
Now all the sudden when the money generating mechanism that IS American Healthcare is bankrupting and eating whole families alive do we - oops! start to take a look at these vaulted 'miracles' of scientific discovery. What rot.
Sure, if you've let yourself get fat, if you've spent decades poisoning you body with toxic estriadol instead of telling the men to 'fold it bud..', if you've bought the beauty-product myth and smeared petrochemically derived goop over your body, if you've got most of the 'new and improved' synthetic products that are so ubiquitous as to be invisible in your home - sure, stick your breasts in a machine, smash them flat and irradiate them too!
Why the heck not? Just drive off a cliff while you're at it.
Sorry if I seem a bit cynical here, but when study after study is pointing to the uncomfortable conclusion that as with so many diseases today, cancer is not much more than a poor lifestyle choice.. It doesn't take a rocket scientist to see that in MOST (though by no means all) cases it can be avoided by careful clean living, that avoids as many exposures to the chemicals and substances that cause this disease. And yes, radiation is one of those causes of cancer.
No one, however is pointing this out in plain terms. Now this of course will do nothing for the older women who blithely took pills instead of keeping their knees shut, and are in an almost constant state of fear for cancer. Too late sisters. Stay on that treadmill, it's all you can really do at this point.
There are still the younger women however, girls who are going to go marching lock-step down that never questioning path of mindless consumerism and the 'just do it' lifestyle of ease that may be setting themselves up for the VERY same misery that's got so many women over 50 having terrors about this disease.
There are MANY things I worry about regarding my health - and I've had really scary lumps come and go in my breasts over the years - but the fact is that I am more likely to drop dead of a heart attack or a stroke.
This fearmongering over breast cancer is a very profitable business and so much of it is founded on issues of personal integrity and fueled by the notion of 'sex without consequences'..
American women should be thermonuclear ANGRY over this baloney they've been sold for the past 50 years. I know I am, and I NEVER bit on that hook!
They should also be angry at those groups that sell this toxic life'style' choice.. Just like the USNews blog right here that is listing an advert for poison.. ermmm.. birth control pills for a "Mere $9 dollars a month.."
It's not 'mere' anything when the health costs are breast cancer and almost perpetual terror of this 'disease' made so common by slick sales marketing..
Glad I am not a mere 'consumer'.
Deb.
Hormone Therapy and Breast Cancer Risk
Rowan Chlebowski's "study" is just more sifting of the largely flawed Women's Health Initiative. There is nothing new here. First of all, there are not only different substances in "hormone replacement therapy," there are different protocols - by mouth, transdermal, etc. Dosing schedules in a rhythm or not, or the levels. Which ones are taken together. All the WHI can prove is that some rather old women (most over 60) show these pattterns when taking drugs from Wyeth - Premarin or Prempro. It's bad enough that our tax dollars go to these tainted studies, it's even worse when the media reports them and gives them more credibility than they deserve.
The "devil you know argument" is a terrible approach when it comes to people's health.
First of all, Deb, I am not going to address your rant on the healthcare system (I have my issues but clearly yours border on paranoia). But, I think its pretty callous of you to suggest that most cancers are due to a lazy lifestyle. Many individuals who do everything "right" get cancer. But, yes, you are correct in ascertaining that there are carcinogenics present everywhere in our environment and that it would behoove you to avoid them as much as possible. Many cancers are formed by genetic mutation and stating most cancers are caused by the environment is inaccurate. Did you ever take the time to consider that as you age and your DNA accumulates mutations, you are more likely to develop cancer? And that maybe an increase in cancer levels is also associated with a larger geriatric population? If you live long enough, you will get cancer. Also, are you aware that estradiol is actually present in every human being both male and female? And it is estradiol, not estriadol. Yep, it is present from birth. And never getting a mammogram, well thats just stupid. Sorry, your response made me angry and I think that it was crafted more out of emotion than actual facts.
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