Estrogen Replacement Therapy in patients with breast cancer

Author: P. Natrajan MD & R. Gambrell MD

Scientific evidence that bio-identical hormone replacement is not only safe but actually lowers breast cancer risk. (Summary of actual article)

The authors cite that there is no direct evidence in the current medical literature to indicate that female hormones worsen the prognosis of cancer. They point to the study by Dr. T. Bush in 2001 that concluded that estrogen and hormone replacement therapy did not increase the risk for cancer compared to women not taking hormones and went on to report that estrogen users were less likely to die from breast cancer than non-users.

In the study here by Dr. Natrajan they selected a group of 123 women, average age 65 years old, all of whom had a prior history of breast cancer. After being treated for breast cancer they were offered hormone replacement therapy. They were divided them into 3 groups:

• Group A: 69 women were given estrogen in many different forms – Pellets, topical and vaginal creams and as oral tablets.
• Group B: 22 women given testosterone as a pellet
• Group C: 32 women given no hormone therapy
  
  They were followed for up to 32 years and monitored for breast cancer occurrence and other outcomes.

Findings: There were 9 eventual deaths from breast cancer, the majority of these occurred in women NOT receiving any hormone therapy.

• Group A: estrogen therapy – 2 deaths (2.9%)
• Group B: testosterone therapy – 1 death (4.5%)
• Group C: No hormone therapy – 6 deaths (18.7%)

The authors compare their findings with 12 other studies published since the year 2000 and report the following:

“There was a consistently lower risk of death from breast cancer in patients who received hormone replacement therapy than patients who had not received hormone therapy. The data are consistent that patients who receive combined hormone replacement therapy are less likely to die of breast cancer than patients who do not receive hormone therapy.”