To: squetch who wrote (11936 ) 12/1/1997 10:23:00 AM From: Henry Niman Respond to of 32384
Here's more positive news for LGND: Minneapolis -St. Paul Star Tribune Scripps Howard News Service M I N N E A P O L I S, Dec. 1 - Women who begin hormone replacement therapy after menopause live longer than women who don't. Using hormones after menopause has been controversial because of fears that they might increase the risk of breast cancer among women who have a family history of the disease. The University of Minnesota Cancer Center study showed that estrogen therapy, known as hormone replacement therapy (HRT), appeared to add years to the lives of women, including those with a family history of breast cancer. That may be partly because breast cancers were detected at an early stage, before they had spread beyond the breast, the researchers said. "We found that women who used hormone replacement therapy to treat menopause or avoid osteoporosis lived longer than those who did not," said Thomas Sellers, director of the study and associate professor of epidemiology and associate director of population studies at the Cancer Center. The research appeared in the latest issue of the journal Annals of Internal Medicine. Iowa Women Studied "We suggest physicians and patients consider these potential benefits from hormone replacement therapy in addition to the possible risk of developing breast cancer." The findings are based on a study of 41,837 randomly selected Iowa women who were between 55 and 69 when researchers began tracking their health in 1986. They were studied until 1994. Sellers said there were fewer deaths among the high-risk women because the hormones appeared to protect them from heart disease, stroke and other forms of cancer, which together are far more likely than breast cancer to kill postmenopausal women. Sellers said that HRT guidelines, published in 1995 in the Journal of the American Medical Association, caution against prescribing the hormones for women who have a family history of breast cancer. The guidelines were created because of evidence that use of estrogen after menopause increased a woman's risk of breast cancer, Sellers said. "There was an absence of studies indicating if there was a reduction in overall risk of death" despite the apparent increase in the risk of breast cancer, he said. Studies Suggest Benefits Since then, several studies have indicated that potential benefits of HRT may outweigh an increased risk of breast cancer. A study of nurses, published two months ago in the New England Journal of Medicine, found no increased risk of dying from breast cancer among those taking HRT. Sellers said the Iowa women who took hormones had a slightly higher rate of breast cancer than those who didn't, but the increase in the risk was so small that it could be a result of chance. "We found that women with a family history of breast cancer who took HRT had a significantly lower total mortality than those with a family history who did not take HRT," Sellers said. However, the rate of breast cancer among women with a family history of the disease was higher than the overall rate for all of the women. The rate was 30 percent higher if just breast cancer was in their family, 70 percent higher if their family histories included breast and ovarian cancer. Although all the women were past menopause, when the risk of breast cancer rises sharply, breast cancer was not as great a cause of death as might have been expected. "There were 1,085 cases of breast cancer in the eight years of follow-up, but more than 2,035 deaths from all causes," Sellers said. "Only 4 percent (87) of the deaths were due to breast cancer. Unfortunately, breast cancer is common. Fortunately, if it is diagnosed early, it is treatable." Much Less Likely to Succumb During the study, the women on HRT were much less likely to succumb to coronary artery disease, stroke or all forms of cancer, he said. Similar findings in the Nurses Health Study and the Cancer Center study are expected to influence discussions between women and their doctors about HRT. "Ultimately, the decision as to whether or not a woman should use hormone replacement therapy is difficult," Sellers said. "Most of the emphasis has been on breast cancer risk. I don't want to minimize that perception because it is real. But it is important to take into consideration the benefits of HRT use in reducing the risk of death." Dr. Sharon Norling, a University of Minnesota gynecologist, said the findings will be an important part of discussions with postmenopausal women. The Cancer Center study's finding-that benefits of improved longevity outweigh the risks of cancer for most women-doesn't mean that all women will decide to use HRT, Norling said. She said the fear of any increased risk of breast cancer may dissuade some women. "Women believe breast cancer is the No. 1 cause of death in women," Norling said. "But 10 times as many will die of heart disease as will die of breast cancer. Using estrogen replacement therapy can reduce the risk of cardiovascular disease."