Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

by Patricia Yarberry Allen, MD | bio

All the major media today are covering the latest findings from the Women’s Health Initiative: Women who took the combined estrogen and progesterone pills to treat menopausal symptoms are at a slightly higher risk for breast cancer even several years after they stop taking the drug.

I do not find this news unexpected or alarming. It makes sense that the initial exposure of breast or endometrial tissue to estrogen and progesterone would continue to have some impact on patients who had used the hormone therapy long enough to stimulate abnormal proliferation of cells.

The women were participants in the WHI combination-hormone study, which was halted prematurely in July 2002 when women who were taking these drugs showed a greater risk for heart attack, blood clots, stroke and breast cancer. The estrogen arm of the study was halted for similar reasons in 2004.

The new findings were published in the Journal of the American Medical Association. They do not change the recommendations that women with moderate to severe menopausal symptoms take the smallest dose of hormones for the shortest amount of time.

The New York Times’ Tara Parker-Pope writes:

Reporting in the current Journal of the American Medical Association, the study’s investigators urge caution in interpreting the results, noting that a woman’s individual risk remains small. The excess cancer risk among former hormone users translates to an added annual risk of 0.3 percent for an individual woman, or three additional cases of breast or other cancers a year among 1,000 women. […]

“What we found in the study is quite consistent with the current guidelines,” said Gerardo Heiss, the report’s lead author and a professor of epidemiology from the University of North Carolina, Chapel Hill. “There is no reason for alarm. The absolute risk is of small magnitude.”

The Washington Post and the L.A. Times both strike more cautionary tones. “People were under the impression that once you stop the hormones, your risk for breast cancer goes down,” Marcia Stefanick of Stanford University, who chairs the steering committee for the federally funded Women’s Health Initiative, tells the Post. “This is saying, ‘No, that’s not the case.’ It continues. It is bad news.”

It’s also important to remember that women today who use hormones are taking much smaller doses — about half of what used to be prescribed.

For more on menopause and the risks/benefits of hormone therapy, visit Ask Dr. Pat.

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