Hormone Replacement Therapy:An Increased Risk of Recurrence andMortality for Breast Cancer Patients?

摘要

Historically, randomized controlled trials (RCTs) have shown an in-creased risk of recurrence and mortality among women who have usedprimarily oral HRT after breast cancer. However, many of these studieshave had design flaws that may impact the findings. Numerous investi-gators have concluded that additional RCTs should be performed, butbecause of ethical issues and logistic challenges, large-scale RCTs areunlikely. Thus, the authors conducted an integrative review investigat-ing recurrence and mortality data among breast cancer survivors whohave used hormone replacement therapy (HRT). They recommend astepwise algorithm for treating vaginal symptoms in breast cancer sur-vivors: (1) start with nonhormonal treatments; (2) progress to a de-tailed discussion among patients and health-care professionals aboutthe current known risks and benefits of vaginal estrogen; and (3) con-clude with mutual decision-making between health-care providers andpatients regarding the use of vaginal estrogen treatment.