NEW ALERT OVER HRT LINKS TO BREAST CANCER

One in 20 cases may be caused by menopause drugs – study

HRT was in the spotlight last night after a major study found it raised breast cancer risks by a third.

Researchers revealed that women aged 50 to 69 were 32% more likely to get the disease if they had taken the most common form of the hormone replacement therapy for at least five years. The danger was twice as high for patients taking it for a decade.

However they found that the overall risk was still small – and doctors said the benefits often outweighed the risks.

Based on 58 global studies, the research suggested that HRT causes around one in 20 cases of breast cancer.

The extra risk lasted for ten or more years after women stopped the treatment. Only those on it for less than a year were found to have no greater or little chance of cancer.

The study showed that 8.3% of patients

‘We don’t want to be alarming’

taking HRT for five years developed breast cancer, compared to 6.3% of women not on the treatment. Its authors said they were concerned that GPs were telling women not to worry about the risks. Without wanting to be ‘unduly alarming’, they suggested guidelines should be updated.

Doctors urged women not to panic however, saying the benefits of relieving night sweats, depression and hot flushes often outweighed the risks. Others pointed out that most HRT patients would start sleeping better and exercising more, improving their health and lowering their background cancer risk.

Published in the Lancet, the research was by the same Oxford University researchers involved in one of the two original – and much smaller – studies in 2002 and 2003 that first raised the breast cancer link. It confirmed these findings and showed the risk persisted longer than thought.

Author Professor Valerie Beral said: ‘This study has brought together all worldwide evidence. It shows a persistent risk of breast cancer for ten to 15 years even after people stop taking menopausal hormone therapy, this was not known about before.

‘Previous estimates of risks are approximately doubled by the inclusion of the persistent risk after use of the hormones ceases. We are concerned GPs are telling women they don’t need to worry about it.’

Co-author Professor Richard Peto said: ‘We don’t want to be unduly alarming but we don’t want to be unduly reassuring. Guidelines should be reconsidered in light of accurate information.’

Currently, the HSE website advises: ‘Hormone Replacement Therapy (HRT) is associated with an increased risk of developing breast cancer. However the risk is a very low one.’

Breast cancer is the most common type of cancer in women in Ireland (excluding skin cancer), according to the health executive. Most women diagnosed with it are over 50, but younger women can also get the disease.

About one in eight women are diagnosed with breast cancer during their lifetime but there is a good chance of recovery if it is detected in its early stages.

Delyth Morgan, of Breast Cancer Care and Breast Cancer Now in the UK, said the study provided important new information. She added: ‘Taking HRT is a personal decision, and it’s vital that everyone fully understands the benefits and risks, discusses them with their GP and is supported to make the decision that’s right for them.

‘These robust findings also tell us more about the long-term impact of different types of HRT on breast cancer risk, and, rather than causing concern, we hope they will help anyone considering HRT treatment to make an even more informed decision.

‘On balance, many women will feel HRT to be a necessity, as it can be really effective in helping them control debilitating menopausal symptoms such as hot flushes. In order to minimise the risk of breast cancer, it is normally recomand mended that the lowest effective dose is used for the shortest possible time.’

Dr Louise Newson, a GP who specialises in the menopause, said: ‘The very small increased breast cancer risk needs to be put in context balanced against the health benefits of HRT. Menopause symptoms can have a debilitating effect and HRT transforms the lives of thousands of women.

‘I see a lot of patients who have had breast cancer and chemotherapy but still choose to take HRT because of the benefits, which include protecting against osteoporosis.

‘Most women on HRT will start sleeping better and exercising more, therefore they improve their overall health lower their background risk of cancer.’

Professor Janice Rymer, of the Royal College of Obstetricians and Gynaecologists in Britain, said patients should be warned of the small increase in risk so they can weigh these up against the costs and benefits.

‘Unfortunately, many women are still suffering in silence and are reluctant to seek advice and support due to concerns around the risks of breast cancer associated with HRT,’ she said. ‘These findings should not put women off taking HRT if the benefits – such as protection of bones and decrease in cardiovascular risk – outweigh the risks.