Published on
Updated
Reading 2 mins.
in collaboration with
Dr Odile Bagot (Gynecologist-obstetrician)
Long decried by many doctors, hormone therapy for menopause would ultimately not be associated with a risk of recurrence of breast cancer, for women in remission from the disease. Update with Dr. Odile Bagot, gynecologist and member of the Doctissimo expert committee.
This is an article published in the journal Journal of the National Cancer Institutewhich announces this important news for all women who have been treated for breast cancer: hormone replacement therapy for menopause is not associated with a recurrence of breast cancer in women treated with Tamoxifen, despite the concerns of some researchers and doctors.
A treatment given for the effects of menopause
These hormone replacement treatments, prescribed during menopause to fight against its effects (vaginal dryness, hot flashes, night sweats, etc.) raised questions about their use in women who survived breast cancer, in particular those suffering from a disease hormone-dependent (estrogen receptor positive).
The same fear arose for those women using vaginal estrogen therapy. Indeed, many doctors used to warn these patients because of the risk of recurrence of their disease in connection with these treatments, demonstrated in two studies dating from the 1990s. Studies which have since been called into question, in due to the small number of participants and short follow-up periods.
A larger study
In addition to questioning these findings, researchers investigated this risk in a large cohort of Danish postmenopausal women treated for early-stage estrogen receptor-positive breast cancer. They compared women who had an early diagnosis of breast cancer between 1997 and 2004 and who had no treatment and those who received 5 years of hormone therapy.
Reassuring results?
Among 8461 women who had not received vaginal estrogen therapy or menopausal hormone therapy before a diagnosis of breast cancer, 1957 and 133 used vaginal estrogen therapy or menopausal hormone therapy, respectively, after diagnosis.
The researchers found no increased risk of recurrence or mortality in those who received either vaginal estrogen therapy or menopausal hormone therapy (although with less definite results in this case).
Few risks for some women
Asked about this study, Dr. Odile Bagot, gynecologist and member of the Doctissimo expert committee, wishes to qualify these results. “The conclusions of the article relate to women who have had hormone-dependent breast cancer treated with Tamoxifen. For them, it is said that local hormonal treatment with vaginal estrogen therapy to treat vaginal dryness does not present a risk. The problem is that the women treated with Tamoxifen are mostly young women who are not confronted with the problems associated with menopause” first details Dr. Bagot.
“For the other patients, whether those taking general hormone therapy or those treated for their cancer with anti-aromatases, the researchers remain cautious.”. A subgroup analysis revealed an increased risk of recurrence, but not mortality, in patients receiving vaginal estrogen therapy with aromatase inhibitors.
Differences in results
These differences in results are due to how different breast cancer treatments work. “In the case of Tamoxifen, there is blockage of estrogen receptors: we do not take many risks by giving treatment to these women. On the other hand, for the anti-aromatase treatment, it is the production of estrogen which is blocked, but the receptors remain free, therefore potentially stimulated by synthetic hormones, and this is what leads researchers to remain cautious. concludes Dr. Bagot.