Although studies have indicated that postmenopausal hormone therapy with estrogen and progestin increases a woman’s risk of developing breast cancer, it is possible that prior postmenopausal hormone therapy may improve a woman’s prognosis once breast cancer occurs. These results were published in the American Journal of Obstetrics and Gynecology.

As women reach menopause and beyond, more than 80% will experience symptoms such as hot flashes, night sweats, sleep disturbance, and vaginal dryness.[[i]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_edn1 "_ednref1")

Estrogen, with or without progestin, is the most effective treatment for many of these symptoms.[[ii]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_edn2 "_ednref2") Recent studies, however, have raised concerns about the health effects of postmenopausal hormone therapy.

Use of estrogen plus progestin has been linked with an increased risk of heart disease, breast cancer, stroke, and blood clots and a decreased risk of fractures and colorectal cancer.[[iii]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_edn3 "_ednref3") Use of estrogen alone, which is generally reserved for women who have had a hysterectomy, has been linked with an increased risk of strokes and a decreased risk of fractures.[[iv]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_edn4 "_ednref4")

Although use of postmenopausal hormone therapy has been linked with an increased risk of developing breast cancer, less information is available about whether use of postmenopausal hormones before a breast cancer diagnosis influences breast cancer prognosis.

To explore breast cancer survival and risk of distant metastases in women who have and have not used postmenopausal hormones, researchers in Germany conducted a study among more than 1,000 breast cancer patients between the ages of 45 and 70.[[v]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_edn5 "_ednref5")

Women were classified as hormone users if they had used postmenopausal hormones (either estrogen alone or estrogen plus progestin) for at least one year before their breast cancer diagnosis. None of the women used postmenopausal hormones after their breast cancer diagnosis.

  • Women who had used postmenopausal hormones were less likely than women who had not used postmenopausal hormones to develop metastases to the bone, lung, or liver.
  • Women who had used postmenopausal hormones also had significantly better overall survival than women who had not used postmenopausal hormones.

The researchers note that it’s still uncertain why breast cancer patients who used postmenopausal hormones before their diagnosis might have better survival with breast cancer. Possible explanations include the anti-hormonal effect of stopping hormone use abruptly at the time of breast cancer diagnosis; differences in lifestyle or healthcare between women who do and do not use postmenopausal hormones; or direct effects of postmenopausal hormones on tumor biology. The researchers also raise the possibility that the beneficial effects of postmenopausal hormones on bones may reduce the likelihood of bone metastases.

Because postmenopausal hormones have a wide range of health effects (both good and bad), women who are considering using postmenopausal hormones are encouraged to discuss these issues with their physician.

References:

[[i]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_ednref1 "_edn1")Gracia CR, Freeman EW. Acute consequences of the menopausal transition: the rise of common menopausal symptoms. Endocrinol Metab Clin N Am. 2004;33:675-689.

[[ii]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_ednref2 "_edn2")NIH State of the Science Panel. National Institutes of Health State-of-the-Science Conference Statement: Management of Menopause-Related Symptoms. Ann Intern Med. 2005; 142:1003-1013.

[[iii]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_ednref3 "_edn3")Rossouw JE, Anderson GL, Prentice RL et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002; 288:321-33.

[[iv]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_ednref4 "_edn4")Anderson GL, Limacher M, Assaf AR et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA. 2004; 291:1701-1712.

[[v]](http://news.cancerconnect.com/postmenopausal-hormone-therapy-may-be-linked-with-better-breast-cancer-prognosis/#_ednref5 "_edn5")Schuetz F, Diel IJ, Pueschel M et al. Reduced incidence of distant metastases and lower mortality in 1072 patients with breast cancer with a history of hormone replacement therapy. American Journal of Obstetrics and Gynecology. 2007;196:342.e1-342.e9.

Related News:Additional Data Strengthens Link Between Hormone Use and Breast Cancer (04/23/2007)

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