Health risks after cessation of postmenopausal hormone therapy

March 04, 2008

The Women's Health Initiative (WHI) investigators have produced another article [1], which probably marks the opening of another set of publications, in which the consequences of a further 2.4-year follow-up (after cessation of the study medication) on the estrogen + progestogen (E + P) cohort are reported. They concluded that, by the end of the post-intervention period, the global index, a newly formed and unvalidated tool used in the WHI trial, was still higher in women randomly assigned to receive E + P compared with placebo.

"After such long and painful debates over the results of the WHI study and the perception that age is a very important determinant of the benefit-risk evaluation, it is really a pity that once again the current information on the extended follow-up period is presented in an unsatisfactory way", says Professor Amos Pines, the President of the International Menopause Society. It seems that the following mistakes were repeated:

  1. There is no mention of the results by age groups and yet, for the age group 50-59 years, the data recorded for the active phase of the WHI E + P arm showed no significant increase in risk of coronary events, strokes and breast cancer in the early postmenopause period. Also, there is no breakdown of the data by years of follow-up. It would be extremely important to know whether the results for the first year post cessation of therapy are similar to those for year 2 and year 3 of follow-up.


  2. The breast cancer results for first-time users of E + P were not presented, whereas breast cancer risk during the active phase of the WHI was similar to that of the placebo group in women with no prior use of E + P.


  3. There is little relevance in the presentation of the combined results for the active phase and the follow-up phase, since it has no real scientific importance. Combining the two periods and grouping the outcomes (all cancers, all cardiovascular events) 'helped' the authors to show significance in some of the variables. However, the overall differences in the annualized rates between the E + P arm and the placebo arm were in the order of 1.5 cardiovascular events per 1000 women/year and 1.2 cancers per 1000 women/year. Again, no data were shown for the younger age group.

"It seems that the WHI investigators have forgotten the turmoil and anxiety they caused in 2002 when they published the preliminary results of the E + P cohort", concluded Professor Pines. By releasing the new data without performing all the necessary, important sub-analyses, women could face another unjustified turmoil related to hormone therapy.
-end-
Reference

1. Heiss G, Wallace R, Anderson GL, et al. JAMA 2008;299:1036

International Menopause Society

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.