BMJ  2005;331:347-349 (6 August), doi:10.1136/bmj.331.7512.347

Education and debate

Hormone replacement therapy and breast cancer: estimate of risk

Nathan J Coombs, surgical fellow1, Richard Taylor, professor2, Nicholas Wilcken, research director1, John Boyages, executive director1

1 New South Wales Breast Cancer Institute, University of Sydney, Westmead Hospital, Westmead NSW 2145, Australia, 2 School of Public Health, University of Sydney, NSW 2006, Australia

Correspondence to: J Boyages johnb@bci.org.au

Patients often ask how population risk data apply to them. This analysis will help doctors to answer that question for women considering hormone replacement therapy

The first 150 words of the full text of this article appear below.

Introduction

The risk of breast cancer arises from a combination of genetic susceptibility and environmental factors. Recent studies show that type and duration of use of hormone replacement therapy affect a women's risk of developing breast cancer.1-7 The women's health initiative trial was stopped early because of excess adverse cardiovascular events and invasive breast cancer with oestrogen and progestogen.6 The publicity increased public awareness of the risks of hormone replacement therapy, and this was heightened by the publication of the million women study.2 However, the recently published oestrogen only arm of the women's health initiative trial suggests that this formulation may reduce the risk of breast cancer.8 To help make sense of the often confusing information,9 women and clinicians need individual rather than population risk data. We have produced estimates that can be used to calculate individual risk for women living up to the age of 79 and suggest the risk . . . [Full text of this article]

Importance of individual data

Calculation of risk

Size of risk

Applicability of estimates

Implications for use


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Rapid Responses:

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Too much information?
Kevin F Donnelly
bmj.com, 6 Aug 2005 [Full text]
Framing risk as minimal is wrong
Prof. Mayer Brezis, MD MPH, Professor of Medicine
bmj.com, 7 Aug 2005 [Full text]
Uncertain estimation
Jane I Galbraith
bmj.com, 15 Aug 2005 [Full text]
Framing breast cancer risk as minimal is wrong
Ellen C G Grant
bmj.com, 16 Aug 2005 [Full text]
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