HRT safe for breast cancer survivors?
Meet the Experts
Debra Barton, Ph.D. is a nurse coordinator at the Mayo Clinic in Rochester, Minnesota, where she directs clinical trials in cancer control and chemoprevention.
Charles Loprinzi, M.D. is an emeritus chairman of the division of medical oncology at the Mayo Clinic in Rochester, Minnesota. Along with hot flash management, his research focuses on ways to reduce pain as well as appetite changes caused by breast cancer treatment.
Jennifer Griggs, M.D., M.P.H. is a medical oncologist specializing in the treatment of breast cancer, with a a special interest in cancer survivorship, patient-physician communication, and quality of care for women with breast cancer.
Question from Dudie B: I am a 48-year-old 8-year survivor (DCIS). After a recent hysterectomy my ob/gyn wanted to put me on Estratest but my breast surgeon said it was too risky. Is it ever safe for survivors to take HRT?
- Answers —Charles Loprinzi, M.D.: The pendulum seems to swing back and forth on the question of estrogen replacement therapy in women who've had breast cancer. Over the past decade or longer, there's been concern about giving these therapies to patients with a history of breast cancer. Interestingly, there are a number of new studies suggesting that estrogen therapy is not the big bad wolf that people thought it was. While the final answer on this is clearly not in, and while most physicians for quite some time are likely to be reluctant to give estrogen to breast cancer survivors, bits of new information suggest again that it's not so bad. Definitive studies—randomized placebo controlled trials—are in progress.
- Jennifer Griggs, M.D., M.P.H.: There are alternatives to hormone replacement therapy for most of the concerns that make physicians want to put somebody on hormone replacement therapy. For example, women at risk for osteoporosis have other alternatives that can be discussed with their medical providers.
- Charles Loprinzi, M.D.: I agree that it's not clear-cut that estrogen needs to be started. The reason for starting estrogen might be for hot flashes, but other things could be tried.
On Wednesday, March 20, 2002, our Ask-the-Expert Online Conference was called Managing Menopausal Symptoms. Charles Loprinzi, M.D., Debra Barton, Ph.D., and Jennifer Griggs, M.D., M.P.H. answered your questions about hot flashes, vaginal dryness, loss of libido, and other symptoms associated with menopause.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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