Estrogen-replacement therapy in younger women with breast cancer
| Autor: | R L, Theriault, R V, Sellin |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Neoplasms Hormone-Dependent Mental Disorders Estrogen Replacement Therapy Antineoplastic Agents Breast Neoplasms Middle Aged Primary Ovarian Insufficiency Combined Modality Therapy Endometrial Neoplasms Premenopause Cardiovascular Diseases Chemotherapy Adjuvant Pregnancy Case-Control Studies Flushing Humans Female Survivors Osteoporosis Postmenopausal |
| Zdroj: | Journal of the National Cancer Institute. Monographs. (16) |
| ISSN: | 1052-6773 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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