Postmenopausal hormone therapy and breast cancer: an uncertain trade-off.

摘要

In 2002, the Women's Health Initiative (WHI) ran-domized trial of placebo vs hormone therapy with estrogen and progestin was stopped early because of evidence of harm. Sales of combined estrogen-progestin plummeted 32% between the period immediately before the study's release and the analogous period 1 year later, as the WHI trial had shown that hormone therapy increased a woman's risk of breast cancer and myocardial infarction. The finding contradicted decades of case-control and observational cohort studies that had suggested that hormone therapy was associated with strong protective effects on the cardiovascular system. The WHI results also undermined a long and successful campaign by hormone replacement advocates to present hormone therapy as a panacea against heart disease, loss of femininity, and other perils of aging.