Estrogen-replacement therapy in younger women with breast cancer.
J Natl Cancer Inst Monogr
; (16): 149-52, 1994.
Article
en En
| MEDLINE
| ID: mdl-7999457
Approximately 25% of breast cancers occur in premenopausal women. In addition to local therapy, surgery or surgery plus irradiation, systemic chemotherapy administration has become the standard of care for all node-positive and many node-negative patients. Systemic adjuvant chemotherapy can result in ovarian dysfunction or failure. This renders many women prematurely estrogen deficient. The consequences of menopause, genitourinary atrophy, bone loss, and increased risk of cardiovascular disease, have not been routinely assessed in clinical trials. The risks of estrogen deficiency have not been assessed in comparison to improved disease-free and overall survival benefits of adjuvantly treated premenopausal breast cancer patients. Estrogen-replacement therapy in postmenopausal women has been shown to prevent osteoporosis and reduce fracture risk. The majority of studies also show a marked reduction in cardiovascular disease and mortality. Estrogen-replacement therapy has been considered a disease-prevention strategy rather than a therapeutic intervention. The risks and benefits of estrogen-replacement therapy in women with primary breast cancer are unknown. It is unknown how the well-known benefits accrued from reduction in skeletal and cardiovascular morbidity/mortality compare with the potential risks of increased breast cancer morbidity/mortality. Carefully designed prospective clinical trials with well-defined objectives and endpoints are required to learn if more harm than good is done by the withholding of estrogen therapy in breast cancer patients.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
/
Terapia de Reemplazo de Estrógeno
/
Insuficiencia Ovárica Primaria
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Middle aged
/
Pregnancy
Idioma:
En
Revista:
J Natl Cancer Inst Monogr
Asunto de la revista:
NEOPLASIAS
Año:
1994
Tipo del documento:
Article
Pais de publicación:
Estados Unidos