Hormone replacement therapy and breast cancer. The European view

Abstract

It is known for years that breast cancer is a hormone-dependent disease and that reproductive factors can contribute to the increase of its incidence. Among the factors, hormone replacement therapy (HRT) appears to be a contributor at least in some women. HRT remains to be the most efficient intervention to alleviate postmenopausal symptoms. However, the possible mild increase in the risk remains a limit to its prescription. From one country to another, regimens are different, and thus, the increase risk can also vary. It is thus important for a clinician to be informed on the evidence concerning the use of such treatments and thus be able, in front of their patients, to evaluate the risk-benefit balance in each case. Because Europe and the USA have different products and different population risks, it is also important to know the data concerning Europe. Indeed, despite the high level of evidence provided by the Women Health Initiative trials, these intervention studies cannot be fully extrapolated to immediate postmenopausal women with different clinical characteristics and different prescriptions. We will review the available information on HRT from European and US studies to provide an overview of the current knowledge on this important question.