Hormone replacement therapy for breast cancer patients doesn’t lead to reoccurrence, study finds

Researchers have confirmed through a new study that hormone replacement therapy for breast cancer patients doesn’t lead to reoccurrence of breast cancer. The paper in the Journal of the National Cancer Institute refutes the worries of some researchers and physicians about hormone replacement therapy.

Women who have survived breast cancer often suffer from hot flashes and night sweats, as well as vaginal dryness and urinary tract infections and all these lead to decline in quality of life which could eventually drive them to discontinue therapy. These symptoms may be alleviated by vaginal estrogen therapy or menopausal hormone therapy. However, the safety of systemic and vaginal estrogen use among breast cancer survivors, particularly those with estrogen receptor-positive disease, has been unclear.

Back in 1990s, two trials for menopausal hormone therapy lead to breast cancer recurrence and this is why many doctors caution breast cancer survivors against using menopausal hormone therapy. While the subsequent studies in the same area haven’t shown increased breast cancer recurrence, the belief continues to persist.

In the new study, researchers investigated the association between hormonal treatment with the risk of breast cancer recurrence and mortality in a large cohort of Danish postmenopausal women treated for early-stage estrogen receptor-positive breast cancer.

Among 8461 women who had not received vaginal estrogen therapy or menopausal hormone therapy before a breast cancer diagnosis, 1957 and 133 used vaginal estrogen therapy or menopausal hormone therapy, respectively, after diagnosis. The researchers here found no increase in the risk of recurrence or mortality for those who received either vaginal estrogen therapy or menopausal hormone therapy.

The study included longitudinal data from a national cohort of postmenopausal women, diagnosed between 1997 and 2004 with early-stage breast cancer who received no treatment or five years of hormone therapy, as ascertained from Denmark’s national prescription registry.

Researchers say that the large cohort study helps to inform the nuanced discussions between clinicians and breast cancer survivors about the safety of vaginal estrogen therapy. The results indicate that breast cancer survivors on tamoxifen with severe genitourinary symptoms can take vaginal estrogen therapy without experiencing an increase in their risk for breast cancer recurrence. However, caution is still advised when considering vaginal estrogen for breast cancer survivors on aromatase inhibitors, or when considering menopausal hormonal therapy.

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