Breast cancer

After the end of a hormone replacement therapy (HRT) on cardiovascular risk disappears, while that of breast cancer persists, according to a survey American. Clearly, the problems posed by hormone treatment of menopause have not finished defray the chronicle: a new study published Wednesday in the Journal of the American Medical Association (JAMA) indicates that the risk of breast cancer associated with hormone replacement of menopause therapy (HRT) continues after stopping treatment. In July 2002, American doctors made public the results of a large clinical trial called the WHI (Women's Health Initiative) to assess the benefits and risks of HRT and which highlighted an increased risk of cardiovascular disease, thromboembolic vein, of breast cancer among women taking hormones after menopause. These findings have significantly reduced the use of alternative treatments around the world and led to limit their prescription to women who really need (unbearable hot flashes, increased risk of osteoporosis). Until then, and since the 1980's, in industrialized countries, proposed to all women, or almost one HRT at the time of menopause. Researchers from the WHI study have continued to monitor the women in this study to determine whether, upon discontinuation of hormone treatment, the cardiovascular risk or breast cancer rejoin equivalent to that of a woman of similar age not taking hormones. The WHI study launched in 1995 focused on 15730 postmenopausal women 50 to 79 years (mean age 63 years) divided into two groups, with half receiving hormone (equine estrogen, synthetic progestins), the other half a placebo . All these volunteers have been actively monitored after stopping hormones in July 2002, and that until March 2005, with a review of health and an annual mammogram. The results of this monitoring showed several important information. On the one hand, women have been treated by a THS taking more and did not have greater risk than others of a heart attack, stroke or deep venous thromboembolism. The risks disappear quickly after stopping the hormones. The dose as small as possible However, the risk of breast cancer after stopping treatment remains almost the same level as when taking hormones for at least two or three years that follow. Thus, there would be 27% of breast cancer in addition to those who were treated compared to other (79 cases with treatment, 60 in the absence of previous treatment). Other surveys on the subject, albeit smaller scale indicated an opposite result, with a return to normal as regards breast cancer after stopping HRT. In addition, during these years of monitoring, there were a total of 63 cases of cancer of all types and more among women than among treated others. For the authors of this work, a first conclusion: it is imperative to continue monitoring through regular mammograms women who received several years hormonal treatment, even after his arrest. A recent analysis has revealed for the first time a decline in the number of new cases of breast cancer in France in 2005, declining to be tied to the drop in the use of hormone treatments since 2002. This small decline of breast cancer was also seen in the United States, Canada and Germany. It is likely that over time, the risk of breast cancer for women previously treated joins that of those who were not. The risk of breast cancer-it depends on the type of hormones used? Some doctors argue that french estradiol used by percutaneous, combined with natural progesterone, would not increase the risk of breast cancer. If this message pay great attention to women, it has not yet been the subject of a scientific demonstration. Currently, the health authorities in France, but also abroad, recommend that the hormone is prescribed in doses as small as possible, for as short a time as possible, not more than five years' salary.