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Postmenopausal Hormone Therapy and Its Association with Breast Cancer

With the cessation of estrogen and progesterone at menopause, the hormone withdrawal affects various systems in the woman's body. In earlier days, menopausal hormone therapy (HT) was prescribed for primary prevention of coronary artery disease (CAD) and osteoporosis, which were thought to be be...

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Autores principales: Syal, Arshi, Aggarwal, Neelam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978047/
https://www.ncbi.nlm.nih.gov/pubmed/33767557
http://dx.doi.org/10.4103/jmh.jmh_284_20
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author Syal, Arshi
Aggarwal, Neelam
author_facet Syal, Arshi
Aggarwal, Neelam
author_sort Syal, Arshi
collection PubMed
description With the cessation of estrogen and progesterone at menopause, the hormone withdrawal affects various systems in the woman's body. In earlier days, menopausal hormone therapy (HT) was prescribed for primary prevention of coronary artery disease (CAD) and osteoporosis, which were thought to be because of estrogen deprivation and epidemiologic data supported a beneficial effect of estrogen on the heart and bone. Later on, robust data from the Women's Health Initiative study comparing two HT trials demonstrated adverse outcomes in terms of excess risk of CAD, stroke, venous thromboembolism, and breast cancer. Even with risk stratification based on family history, approximately only 15% of women diagnosed with breast cancer have such a risk factor. This implies that family history will not be elicited in more than 85% of women who develop breast cancer. Literature review suggests that the prior use of conjugated equine estrogen (CEE) alone has the potential to be effective as an intervention, leading to a reduction in mortality due to breast cancer. Therefore, it is time to reevaluate the risk reduction strategies for breast cancer that are currently in practice. In terms of absolute numbers, for every 10,000 person-years of prior use of CEE alone, there would be only two fewer deaths from breast cancer and two fewer deaths secondary to its sequelae. This translates into a significant number of women in our country with a population of 1.38 billion (of which 48%, nearly 650 million, are women).
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spelling pubmed-79780472021-03-24 Postmenopausal Hormone Therapy and Its Association with Breast Cancer Syal, Arshi Aggarwal, Neelam J Midlife Health Narrative Review With the cessation of estrogen and progesterone at menopause, the hormone withdrawal affects various systems in the woman's body. In earlier days, menopausal hormone therapy (HT) was prescribed for primary prevention of coronary artery disease (CAD) and osteoporosis, which were thought to be because of estrogen deprivation and epidemiologic data supported a beneficial effect of estrogen on the heart and bone. Later on, robust data from the Women's Health Initiative study comparing two HT trials demonstrated adverse outcomes in terms of excess risk of CAD, stroke, venous thromboembolism, and breast cancer. Even with risk stratification based on family history, approximately only 15% of women diagnosed with breast cancer have such a risk factor. This implies that family history will not be elicited in more than 85% of women who develop breast cancer. Literature review suggests that the prior use of conjugated equine estrogen (CEE) alone has the potential to be effective as an intervention, leading to a reduction in mortality due to breast cancer. Therefore, it is time to reevaluate the risk reduction strategies for breast cancer that are currently in practice. In terms of absolute numbers, for every 10,000 person-years of prior use of CEE alone, there would be only two fewer deaths from breast cancer and two fewer deaths secondary to its sequelae. This translates into a significant number of women in our country with a population of 1.38 billion (of which 48%, nearly 650 million, are women). Wolters Kluwer - Medknow 2020 2021-01-21 /pmc/articles/PMC7978047/ /pubmed/33767557 http://dx.doi.org/10.4103/jmh.jmh_284_20 Text en Copyright: © 2021 Journal of Mid-life Health http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Narrative Review
Syal, Arshi
Aggarwal, Neelam
Postmenopausal Hormone Therapy and Its Association with Breast Cancer
title Postmenopausal Hormone Therapy and Its Association with Breast Cancer
title_full Postmenopausal Hormone Therapy and Its Association with Breast Cancer
title_fullStr Postmenopausal Hormone Therapy and Its Association with Breast Cancer
title_full_unstemmed Postmenopausal Hormone Therapy and Its Association with Breast Cancer
title_short Postmenopausal Hormone Therapy and Its Association with Breast Cancer
title_sort postmenopausal hormone therapy and its association with breast cancer
topic Narrative Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978047/
https://www.ncbi.nlm.nih.gov/pubmed/33767557
http://dx.doi.org/10.4103/jmh.jmh_284_20
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