Latest HRT research

[googlepoodle]

Hi
Can't link because on phone but wondered if anyone had any views on recent research in news on those with HRT more likely to get breast cancer (if on oestrogen and progesterone).
My initial reading is of 39000 women followed, 2% got breast cancer and for this 2% those on HRT were three times more likely to contract it.

It's probably quicker for me to suggest you read the thread on the forum of Menopause Matters website.

www.menopausematters.co.uk/forum/index.php/topic,32927.0.html

There is a statement there from Dr Heather Currie, chairman of the British Menopause Society, a link to the BMS' own press release on it www.menopausematters.co.uk/newsitem.php?recordID=174/RCOG-BMS-response-to-Breast-Cancer-Now-Generations-Study-on-HRT-use-and-breast-cancer-risk

and a link to the actual research paper itself- which has so far only been published in Nature magazine, not fully released.

Nature journal

It's vital to appreciate that this research shows nothing new and the drugs included in the study did not include progesterone. Progesterone is a natural hormone, available for HRT as 'micronised progesterone' trade name Utrogestan.

The types of HRT used in the research- which I have read from the web- were HRT pills and patches which used 'progestogens' - these are forms of synthetic progesterone.

The figures show an increase, depending on BMI, from 1.00 to 3.2. So 2 more cases per 100. The confidence interval for these is huge (CI 95%) so these figures above are an average - they could be lower they could be higher.

The report is based on observational studies where women reported their experiences. It is not a double blind placebo trial. There is no weighting for lifestyle such as drinking or being sedentary, or family history. That is why the BMS says 'it has flaws'.

It's important to put the stats - if they are right- into perspective because both drinking 2 units a day or being overweight, raise the risks higher than using HRT.

It is a relative risk. It increases your risk by 3 times, but you do not know what that risk is to start with - it may be none.

It raises the risk whilst you are taking it, but does not cause it. This can be seen when people stop taking it, as the risk goes back down again.

It is not something that was previously unknown and the committee working on the new NICE menopause guidelines took this into account.

Drinking raises the risk much higher.

If you read more about the Breakthrough Generational Study, you will find that they are putting a lot of effort into finding the reasons why people get breast cancer, which is more interesting.

I agree.

You can work out your risk with a tool like this:

www.cancer.gov/bcrisktool/

There are some things you can't change re. risk now, (ie - age for first period, age when giving birth) some things you can do now to lengthen the odds.

The average risk in the UK is 1:8 . Lifestyle changes- diet, exercise, etc- may reduce it to 1:9 or 1:10 etc etc.

There is a lot of research out there on the use of natural progesterone as part of HRT and all of it shows no increase in BC. The French E3N study is one. www.ncbi.nlm.nih.gov/pmc/articles/PMC2211383/

Unfortunately, this information doesn't appear to trickle down to GPs because it's specialist and unless they have an interest they won't go on training courses or read up on the research.

The BMS thinking on HRT is that some types may in some women promote a cancer that was already there, (as small as one cell) but it doesn't cause it.