Hormones and breast cancer – oncologist’s remarks

For many years hormonal replacement therapy (HRT) was prescribed either to relief climacteric symptoms or to decrease risk of caridiovascular diseases, osteoporosis and to make ageing process during menopause slower.
Results of many randomized studies did not prove HRT beneficial effects in decreasing risk of coronary disease. Some authors suggest increased cardiovascular risk in women using this therapy. Many retrospective studies proved that breast cancer risk is higher in HRT users and it increase with HRT duration. Last trials suggest that this risk is more increased when progestins are added to estrogens treatment. On the other side „HRT induced” breast cancer is less malignant, has better differntiation and is more sensitive to therapy. HRT increases endometrial cancer risk, especially when only estrogens are used. At present it is neccesary to limit HRT indications to menopausal symptoms relief: vaginal dryness, hot flushes, sweats and osteoporosis prevention. HRT use in women after breasr cancer treatment without disease symptoms is still an open field. Regardless stopped recrutation for HABITS study it is necessary to wait ror results of ongoing other studies.
Main topics in HRT are following: „tailored therapy”, low doses introduction and therapy individualization.