The last century, 40 years conjugated estrogen Premarin (conjugated equine es-trogen, premarin) listed and formally applied to clinical, from hormone replacement therapy (hormone replacement therapy, HRT) in postmenopausal women has been increasing understanding and acceptance of HRT may a significant relief of menopausal symptoms, prevention of urogenital atrophy, effectively increase the cortical bone and trabecular bone mineral density (bone min-eral density, BMD) and whole body bone mineral content (bone mineral content, BMC), prevention and treatment of osteoporosis loose. However, HRT in postmenopausal women to enjoy their happiness and quality of life brought about improvements, people gradually discovered that the reproductive HRT. Digestion and many other systems have different levels of carcinogens. Impairment and other side effects and complications, hence limiting HRT The clinical application. To correctly understand and deal with negative effects of HRT on various systems to become an important issue in modern clinical medicine, this paper far as the impact of HRT on breast cancer and its treatment measures for review.
In July 2002, U.S. Women’s Health Study (Women’s Health Initia-tive WHI) reported using estrogen. Progestogen continuous combined treatment of the medium-term conclusion: on average 5.2 years of observation found that compared with the placebo group of women receiving HRT invasive breast an increased risk of cancer by 26%! a result was one of shock and panic of the HRT, continuous combined HRT trial is also mentioned for this purpose to terminate. Holmberg, etc. Zeng Yi 434 cases of breast cancer patients randomized clinical trial, according to whether hormone replacement therapy to be divided into two groups according to plan, want to treat 2-year follow-up 5 years. Follow-up of 2.1 years later, women in the HRT group of 26 patients with new lesions in the control group and only 7 new cases of lesions, the difference was significant, the relative risk of breast cancer, a new hair line from 3.3 (95% CI1.5 ~ 7.4), this experiment was forced to be prematurely terminated. But it is worth pondering is that in the just-concluded WHI estrogen-alone branch in 7 years showed no increase in risk of breast cancer. Several recent observational studies suggest that while patients with breast cancer after HRT found no increase in recurrence and cancer-related mortality or total mortality. Peters and other follow-up of 607 cases of breast cancer patients, of which 56 cases received the diagnosis of breast cancer after HRT treatment, follow-up of 12.8 years (4.7 to 38.9 years), resulting in HRT group, 1 case of local recurrence, 1 case of contralateral breast cancer, 92.5 % cancer-free survival of 15 years, it would be compared to HRT users and non-users are usually good prognosis, no increase in cancer recurrence or a new hair. Decker and other pairs of 277 cases of breast cancer patients with HRT treatment, and the same age. Period do not. Pathology and in patients treated with chemotherapy without HRT pairing of research, observation and found in situ in the unilateral recurrence. Contralateral foci occurrence and systemic transfer of in no significant difference between the two groups. This HRT and breast cancer, especially breast cancer, the relevance of Beishou doctors and patients concerns.
Estrogen. Progestin hormones, etc. is to promote the differentiation of normal breast tissue. Development of the determinants, most breast tumors. The development and treatment are closely related with these hormones. 91,523 cases of female participants in a related study of the relationship between sex hormones and breast, 14-year period found that 2341 cases of breast cancer, case-control studies have shown that: for each additional two-year-old age at menarche, breast cancer incidence by about 10%, amenorrhea for every age increase in a year, a corresponding increase in the incidence of breast cancer by about 3%, these studies show that the earlier age at menarche, amenorrhea later age, the more persons, the higher the prevalence of breast cancer, suggesting that there are longer periods of time, breast cancer prevalence rate. A large number of studies have shown that: the higher the concentration of serum estrogen, the higher the prevalence of breast cancer. Epidemiological studies have shown that combination therapy of estrogen and progestin effects on breast cancer risk than estrogen alone, radiographic examination showed that the former a great impact on breast density. Recently the British Million Women Study (MWS) showed an increased risk of breast cancer with HRT, especially in the drug the first one year, until 5 years after stopping a risk of disappearing. Colditz combination of 31 epidemiological data suggest that: being applied HRT to women suffering from breast cancer relative risk (RR) of 1.02 ~ 1.40, HRT treatment ≥ 5 ~ 10 years, RR = 1.46, of which aged 60 to 64 years of age RR = 1.70. U.S. Women’s Health Study (WHI) study results indicate that 5-year follow-up, HRT group four years, the incidence of breast cancer and the control group no significant difference, 4 years after the HRT group an increased risk of breast cancer (per 1000 women in an increase of 4 cases). Another looked at a number of studies of women with benign breast tumors of the use of HRT, the majority view that the incidence of breast cancer is not increased, so that the benign breast tumor is not a contraindication for HRT.
In sum, sum up the majority of research data, the current consensus view is that the more: HRT used in conjunction is less than 5 years not to increase the risk of breast cancer, long-term (5 years) estrogen and progesterone used in HRT and the risk of breast cancer increased significantly. The use of HRT during and out HRT5 years, should be based on the situation in April Check every 1 ~ 1 second breast, if necessary, the use of breast-infrared instrument. Breast ultrasound. Mammography breast-aided detection. Condensate breast cancer should be discontinued, and actively carry out further examination of breast cancer, if necessary, surgery. Fiber cystic hyperplasia in patients with benign breast disease through the security screening, if any indication, you can close follow-up to use HRT. Risk factors include family history of breast cancer. Are not produced. Primiparous late. Postmenopausal late. High-fat diet. Obesity, with a single risk factor was not the benign breast lesions in patients with HRT taboo, but if multiple risk factors that may affect a larger take the individual treatment.
That have been suffering from breast cancer in postmenopausal women with HRT can be applied to the question whether it is currently controversial. While HRT can lead to an increase in incidence of breast cancer, but still can not get from the current study HRT and breast cancer are directly related to conclusions. Some research and exploration found that: to accept or not accept HRT, no significant difference in survival sex. There is no such forward-looking studies have shown that patients with breast cancer risk of HRT. Therefore, no definite evidence that HRT with breast cancer can not be applied to improve the quality of life. While suffering from breast cancer in postmenopausal women do not recommend routine use HRT, but the application of HRT in patients with the request, in the absence of a better way to alleviate the severe case of post-menopausal symptoms, it would not have to avoid HRT.