Hormone replacement therapy (HRT) after breast cancer (BC).

A Gorins, MD, M. Espie, MD, N. Bedairia, MD, F. Perret, MD, B. Tournant, MD, H Nowak, MD, E. Lucci, MD, M. Marty, MD.

Centre des Maladies du Sein, Saint Louis Hospital Paris and Gustave Roussy Institut Villejuif France

Aim: to evaluate the impact of HRT on patients with a personal history of breast cancer Methods: * Design: open, prospective study * Inclusion criteria: - menopausal women with a history of BC (any pathologic form) - disease-free interval of 2 years before HRT - severe symptoms of menopause resistant to non hormonal therapy * Exclusion criteria: - history of thromboembolism - severe metabolism disease - other active cancer * Treatment: Estradiol 1 mg/day + progestin, combined , 26 days per month. * Follow-up: - every 3 months the first two years, every 6 months after - clinical investigations (menopausal symptoms, breast recurrence) - complete investigation (markers, mammogram, bone and liver scan) every year Results: * 230 patients have been included in this study. Median duration of HRT is 2.2 years. * 14 patients experienced a relapse (5 contralateral BC, 5 local relapses in pts with breast conserving therapy, 4 metastatic progression). None of them have died. * HRT was stopped in 16 % of the patients because of side effects and/or anxiety, a figure that docs not exceed the one known for post menopausal women with HRT. * 98 % of patients have a dramatic improvement of symptoms (flushes, dyspareunia) * 80 % cases with initial osteoporosis have an improvement of bone mineral density Conclusion: Our results are in agreement with those of other studies and indicated that HRT following breast cancer does not carry detrimental effects on breast cancer while achieving its expected beneficial effects.

KEY WORDS: Breast cancer, Hormone Replacement Therapy (HRT), Menopause.

For more information, contact

Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Risk Assessment, Part 1.