Quit HRT, Cut Cancer Risk

Did last year's news linking hormone replacement therapy (HRT) with an increased risk of breast cancer leave you wondering about the long-term effects of HRT, even after you quit? New research showing that cancer risk drops after women stop taking the hormones should come as a welcome piece of news in an oft-heated debate (Journal of Obstetrics and Gynecology, 2002, vol. 100, no. 6).

The bottom line for hormone therapy is to be certain why you are taking it. Lead researcher Linda K. Weiss, PhD, of the National Cancer Institute in Bethesda, Maryland, studied 3,500 women and found that those who had used an estrogen and progestin combination for more than five years were 54 percent more likely to receive a breast cancer diagnosis while taking the medication than those who never used that type of HRT. However, women who had stopped that HRT therapy at least six months prior to the study's start were no more likely to have breast cancer than those who never used HRT.

"The positive take-home message from this paper is that the risk of breast cancer goes away when you stop taking HRT," says Cynthia Stuenkel, MD, a clinical professor of medicine and endocrinology and metabolism at the University of California, San Diego. "The bottom line for hormone therapy is to be certain why you are taking it. In the past, we had women taking it for long-term prevention of certain diseases, but this isn't the case anymore. If women take it for specific symptom relief, they need to reassess that every year. Hot flashes, for example, go away with time."

Robert Spirtas, DrPH, who helped analyze data for the study, notes that pregnant women and women who take birth control pills are also at an increased risk of breast cancer. As with the HRT findings, when women stop taking oral contraceptives or are no longer pregnant, their risk returns to its previous level. "As scientists, we do the best job we can of supplying the potential risks and benefits, but not all of us are clinicians," says Spirtas. "It's the doctor's job to talk to women about these risks and benefits and help each woman ultimately make the decision about how she wants to treat her symptoms of menopause."

—Shanti Sosienski