A special report in the April 19 issue of the New England Journal of Medicine [1] brings initial analysis of data from the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) registries, showing that the incidence of breast cancer in women in the US fell by 6.7% in 2003, and stayed at the same level in 2004. The decrease was evident only in women who were 50 years of age or older, and solely involved cancers that were estrogen receptor-positive. The investigators suggested that a plausible explanation for the unexpected data is the concomitant sharp decrease in the use of postmenopausal hormones, which followed the first report from the Women's Health Initiative (WHI) study in mid-2002.
While being pleased with these new data on the incidence of breast cancer, the International Menopause Society (IMS) advises caution in linking these two parallel trends observed in the US. Any attempt to put both observations into one framework is premature and there is little scientific basis for such an assumption. In fact, the authors themselves mention in the manuscript that other factors might have contributed to these changes in breast cancer incidence. Nevertheless, the reader of the article still receives a clear message on the presumed association with hormone therapy (HT).
The IMS wishes to stress the following relevant facts:
The IMS maintains its recommendation that HT should be prescribed whenever indicated. The use of hormones in early menopause and up to age 60 years has a very minor potential for harm, but carries substantial benefits. Women should decide annually whether they wish to continue treatment after consultation with their caregiver [3].
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THE INTERNATIONAL MENOPAUSE SOCIETY
The aims of the Society (IMS) are to promote knowledge, study and research on all aspects of aging in men and women; to organize, prepare, hold and participate in international meetings and congresses on menopause and climacteric; and to encourage the interchange of research plans and experience between individual members. The Society is a non-profit association, within the meaning of the Swiss Civil Code. It was created in 1978 during the first World Congress on the Menopause. In addition to organizing congresses, symposia, and workshops, the IMS owns its own journal: Climacteric. See website: www.imsociety.org
New England Journal of Medicine