> Table 58: Postmenopausal hormone use after breast cancer diagnosis and recurrence
This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.
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Introduction: Postmenopausal hormone use increases the risk of developing breast cancer (see Table 8) [1]. For this reason, women are advised to avoid long-term use of postmenopausal hormones.
There has been concern these hormones might also increase the risk of recurrence in breast cancer survivors. Much of the research done to date has not found a link between postmenopausal hormone use and breast cancer recurrence. However, one large randomized controlled trial showed an increased risk of recurrence in women who used postmenopausal hormones after breast cancer diagnosis compared to those who did not.
Learn about the strengths and weaknesses of different types of studies.
Study selection criteria: Randomized controlled trials, prospective cohort studies and pooled analyses.
Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.
Study
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Study Population
(number of participants)
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Follow-up
(months)
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Relative Risk of Recurrence Among Women Who Used Postmenopausal Hormones after Breast Cancer Compared to Those Who Did Not,
RR (95% CI)
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Randomized controlled trials
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Holmberg et al. [2]
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442
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48
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2.2 (1.0-5.1)
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von Schoultz and Rutqvist [3]
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378
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49.2
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0.82 (0.35-1.90)
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Cohort studies
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Dew et al. [4]
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1472
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87.6
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0.24 (0.10-1.49)*
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O'Meara et al. [5]
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869
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44
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0.5 (0.3-0.85)
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Vassilopoulou-Sellin et al. [6]
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319
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40
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0.5 (0.1-3.8)
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Durna et al. [7]
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277
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76
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0.75 (0.29-1.95)†
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Eden et al. [8]
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270
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24
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0.4 (0.2-0.9)
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Beckmann et al. [9]
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185
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32
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0.7 (0.3-1.6)
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Pooled analyses
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Col et al. [10]
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837
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30
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0.6 (0.4-1.2)
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*Among women with estrogen receptor-positive breast cancer.
†Among women diagnosed with premenopausal breast cancer.
References
1. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA. 288(3):321-33, 2002.
2. Holmberg L, Iverson OE, Rudenstam CM, et al., for the HABITS Study Group. Increased risk of recurrence after hormone replacement therapy in breast cancer survivors.J Natl Cancer Inst. 100(7):475-82, 2008.
3. von Schoultz E and Rutqvist LE on behalf of the Stockholm Breast Cancer Study Group. Menopausal hormone therapy after breast cancer: the Stockholm randomized trial. J Natl Cancer Inst. 97(7):533-5, 2005.
4. Dew JE, Wren BG, Eden JA. Tamoxifen, hormone receptors and hormone replacement therapy in women previously treated for breast cancer: a cohort study. Climacteric. 5(2):151-5, 2002.
5. O’Meara ES, Rossing MA, Daling JR, et al. Hormone replacement therapy after a diagnosis of breast cancer in relation to recurrence and mortality. J Natl Cancer Inst. 93:754-62, 2001.
6. Vassilopoulou-Sellin R, Asmar L, Hortobagyi GN, et al. Estrogen replacement therapy after localized breast cancer: clinical outcome of 319 women followed prospectively. J Clin Oncol. 17(5):1482-7, 1999.
7. Durna EM, Heller GZ, Leader LR, et al. Breast cancer in premenopausal women: recurrence and survival rates and relationship to hormone replacement therapy. Climacteric. 7(3):284-91, 2004.
8. Eden JA, Bush T, Nand S, et al. A case-control study of combined continuous estrogen-progestin replacement therapy among women with a personal history of breast cancer. Menopause J North Am Menopause Soc. 9:67-72, 1995.
9. Beckmann MW, Jap D, Djahansouzi S et al. Hormone replacement therapy after treatment of breast cancer: effects on postmenopausal symptoms, bone mineral density and recurrence rates. Oncology 60:199-206, 2001.
10. Col NF, Hirota LK, Orr RK, et al. Hormone replacement therapy after beast cancer: a systematic review and quantitative assessment of risk. J Clin Oncol. 19(8):2357-2363, 2001.
Updated 02/10/12
