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Is Hormone Therapy Safe for Breast Cancer Survivors?

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American Cancer Society spokeswoman Debbie Saslow, PhD, agrees that larger studies with different designs are needed to confirm that HRT is safe for women with a history of breast cancer. Women and their doctors cannot assume the therapy is safe based on just this study, she says, because patient numbers were small, follow-up times were short, and most patients had very early stage breast cancers at diagnosis.

"If this study does anything, I would say that it may help calm concerns about very short-term therapy in women treated for these early stage cancers," she says. "If a woman who fits this profile needs a very short-term therapy fix with HRT to get her past the most severe period of menopause symptoms, that may be safe."

Saslow points out that 80% of the women included in the study were treated with estrogen alone, instead of estrogen plus progestin. The combination treatment is more widely associated with breast cancer risk, she adds.

"The type of hormone therapy these women were taking has a much smaller effect on their breast cancer risk," she says. "This is a very important point that was not really brought out by the authors."

Saslow says it is not clear whether definitive studies of hormone safety would be done in the U.S., because breast cancer survivors and their doctors might be unwilling to take the risk.

"In my opinion," she says, "this study does very little to relieve the caution, but if the European trials suggest hormone therapy is safe, it might be possible to do a large trial in this country."

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