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HRT and Breast Cancer Controversy The German Cancer Aid organization is studying menopausal women to learn more about a potential link between hormone replacement therapy (HRT) and increased risk of breast cancer. Concerns about HRT first surfaced widely when the US Women's Health Initiative cut short its trial of 16,000 women taking HRT when questions were raised about the possible risk of stroke, heart attack and breast cancer. The upcoming German study will involve 10,000 women between the ages of 50 and 74, some who have had breast cancer and some who have not. In August 2002, the United Kingdom Medical Research Council recommended that a UK trial of hormone replacement therapy of 22,000 women continue, despite concerns from other groups. Who is right? The National Women's Health Network complains that a key problem is that women do not have solid facts upon which to make wise choices. What is known about HRT has been gleaned from observing women who used the drugs and agreed to participate in a study. A clinical study is formal and controlled and can presumably yield more specific and reliable results. HRT Connection Still Under Study One study that caused concern was conducted between 1996 and 1998 and involved 5,212 postmenopausal women between 40 and 96 years old living in Washington state. According to that study, published in January 2001, HRT increases breast density. And increased density calls into question the accuracy of mammogram results. Other studies had already associated increased density with higher rates of breast cancer. In September 2001, an international panel of experts revised treatment guidelines to specify that they be based on whether the tumor responds to endocrine or not. It recommended that "all patients with endocrine-responsive tumors, even those at minimal or low risk of recurrence, receive anti-hormonal therapy." Searching for The Cause Researchers continue to look for causes of breast cancer. One recent study sought to discover whether on-the-job exposure to electromagnetic fields could be a factor. Out of 843 cases of the disease and 773 controls (women without the disease), the study's findings "give little support to the hypothesis that electromagnetic fields cause cancer of the female breast." The search for a cure and a cause continue. Resources American Society of Clinical Oncology. (2001). Important role of hormone status in adjuvant treatment of primary breast cancer. Retrieved August 9, 2002, from www.asco.org/asco/ascoMainConstructor/1,47468,_12|002167| 00_18|0011055|00_19|0011056|00_20|001,00.asp Rutter, C. M., Mandelson, M. T., Laya, M. B., Taplin, S. (2001, January 10). Changes in breast density associated with initiation, discontinuation, and continuing use of hormone replacement therapy. Journal of the American Medical Association, 285(2). Retrieved August 9, 2002, from www.mindfully.org/Health/Breast-Density-Hormone- Therapy.htm#paper. Van Wijngaarden, E., Nylander-French, L. A., Millikan, R. C., Savitz, D. A., Loomis, D. (2001). Population-based case-control study of occupational exposure to electromagnetic fields and breast cancer. Retrieved August 9, 2002, from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=11399443&dopt=Abstract.

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