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Hormone Molecular Biology and Clinical Investigation

Editor-in-Chief: Pasqualini, Jorge R.

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Benefits and risks during HRT: main safety issue breast cancer

1 / Xiangyan Ruan2

1University Women's Hospital of Tuebingen, Tuebingen, Germany

2Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China

Corresponding author: Professor Dr. Alfred O. Mueck, MD, PharmD, PhD, University Women's Hospital, Calwer Strasse 7, D-72076 Tuebingen, Germany Phone: +49-7071-2984801, Fax: +49-7071-284801

Citation Information: Hormone Molecular Biology and Clinical Investigation. Volume 5, Issue 2, Pages 105–116, ISSN (Online) 1868-1891, ISSN (Print) 1868-1883, DOI: 10.1515/HMBCI.2011.014, March 2011

Publication History

Received:
2011-02-12
Accepted:
2011-02-18

Abstract

To assess the benefits and risks during hormone replacement therapy (HRT) in postmenopausal women, the only placebo-controlled study testing clinical endpoints with high statistical power has been the Women's Health Initiative (WHI). Although this trial, conducted mainly in older high-risk women, might not reflect the practical conditions for the normal use of HRT, the WHI for the first time provides the main risks in relative as well as in absolute numbers, which are venous thromboembolism and breast cancer, and in older women also myocardial infarction and stroke. Proven benefits such as treatment of climacteric symptoms, reduction of osteoporotic fractures and decrease of colon cancer risk seem to be only important for younger women, because only with early start of HRT cardiovascular risks can be reduced. Reduction of cardiovascular risks can be achieved using transdermal HRT, which, however, was not tested in a placebo-controlled study design similar to that in the WHI. This review focuses on the results of the WHI, comparing different age groups, and in general especially on the main fear of women, risk of breast cancer, which has been defined as a special project between two universities, a close collaboration of a German and Chinese research group.

Keywords: benefits; breast cancer; hormone replacement therapy (HRT); risks

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