scholarly journals Large-scale hormone replacement therapy and life expectancy: results from an international comparison among European and North American populations

2000 ◽  
Vol 90 (9) ◽  
pp. 1397-1402 ◽  
Keyword(s):  
Hormone Replacement Therapy ◽  
Life Expectancy ◽  
Replacement Therapy ◽  
International Comparison ◽  
North American ◽  
Large Scale ◽  
Hormone Replacement

Hormone Replacement Therapy and Life Expectancy After Prophylactic Oophorectomy in Women With BRCA1/2 Mutations: A Decision Analysis

2004 ◽  
Vol 22 (6) ◽  
pp. 1045-1054 ◽  
Author(s):  
Katrina Armstrong ◽  
J. Sanford Schwartz ◽  
Thomas Randall ◽  
Stephen C. Rubin ◽  
Barbara Weber
Keyword(s):  
Hormone Replacement Therapy ◽  
Life Expectancy ◽  
Decision Analysis ◽  
Replacement Therapy ◽  
Prophylactic Mastectomy ◽  
Hormone Replacement ◽  
Sensitivity Analyses ◽  
Decision Analytic Model ◽  
Prophylactic Oophorectomy ◽  
The Impact

Purpose The decision about prophylactic oophorectomy is difficult for many premenopausal women with BRCA1/2 mutations because of concerns and controversy about the use of hormone replacement therapy (HRT) after oophorectomy. Patients and Methods A Markov decision analytic model used the most current epidemiologic data to assess the expected outcomes of prophylactic oophorectomy with or without HRT (to age 50 years or for life) in cohorts of women with BRCA1/2 mutations. Sensitivity analyses were conducted to assess the impact of alternative assumptions about effects of HRT, effects of prophylactic oophorectomy, and risks of cancer associated with BRCA1/2 mutations. Results In our model, prophylactic oophorectomy lengthened life expectancy in women with BRCA1/2 mutations, irrespective of whether HRT was used after oophorectomy. This gain ranged from 3.34 to 4.65 years, depending on age at oophorectomy. Use of HRT after oophorectomy was associated with relatively small changes in life expectancy (+0.17 to −0.34 years) when HRT was stopped at age 50, but larger decrements in life expectancy if HRT was continued for life (−0.79 to −1.09 years). HRT was associated with a gain in life expectancy of between 0.39 and 0.79 years for mutation carriers undergoing both prophylactic mastectomy and oophorectomy. Conclusion On the basis of the results of this decision analysis, we recommend that women with BRCA1/2 mutations undergo prophylactic oophorectomy after completion of childbearing, decide about short-term HRT after oophorectomy based largely on quality-of-life issues rather than life expectancy, and, if using HRT, consider discontinuing treatment at the time of expected natural menopause, approximately age 50 years.

It is all in the name: The importance of correct terminology in hormone replacement therapy

2020 ◽  
Vol 26 (3) ◽  
pp. 142-146 ◽  
Author(s):  
Roxanna Pirhadi ◽  
Vikram Sinai Talaulikar ◽  
Joseph Onwude ◽  
Isaac Manyonda
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement Therapy ◽  
Life Expectancy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Dramatic Reduction ◽  
Dementia Risk ◽  
Adult Lives ◽  
Global Increase ◽  
New Perspective

The global increase in life expectancy to 74 years for women, while the median age of the menopause remains at 51 years, means that an increasing number of women will live a significant portion of their adult lives in the menopause. The WHI publications in 2003/4 reported on the dangers of hormone replacement therapy, in particular with respect to breast cancer and dementia risk. This resulted in a dramatic reduction in hormone replacement therapy prescription and use. However, the findings from the WHI studies have been re-appraised, and the new perspective is reflected in the guidance published by NICE in 2015 in which they recommended that more women be offered hormone replacement therapy as the benefits are now perceived to outweigh the risks for most women. However, controversy continues to surround hormone replacement therapy, and there are probably few areas in medicine where the misuse of terminology causes quite as much confusion as in hormone replacement therapy. Commonly used terms such as ‘menopausal hormone therapy’ and ‘hormone replacement therapy’ lack specificity and there is an urgent need for correct terminology to accurately describe the hormones replaced.

Hormone-replacement therapy may be associated with increased incidence of luminal breast cancer: Results from a large-scale health maintenance organization (HMO) analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13599-e13599
Author(s):  
Nava Siegelmann-Danieli ◽  
Vered Rosenberg ◽  
Avital Bareket-Samish ◽  
Gabriel Chodick ◽  
Varda Shalev
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Large Scale ◽  
Triple Negative ◽  
Hormone Replacement ◽  
Luminal Breast Cancer ◽  
Luminal A ◽  
Health Maintenance ◽  
Over Expression

e13599 Background: Trends in breast cancer (BC) incidence may be impacted by potentially competing variables (e.g., mammography rates, hormone-replacement therapy [HRT] use). Methods: This observational retrospective study examined trends/associations between BC incidence, mammography rates, and HRT use among female members of the Maccabi Healthcare Services (the second largest HMO in Israel).BC subtypes were determined based on therapies received by patients diagnosed after 2006 (following trastuzumab approval in the adjuvant setting). Results: Between 2002 and 2014, 14,092 BC cases (88% invasive, 12% in-situ) were identified. The age-adjusted incidence rate of invasive BC peaked in 2005, consistent with increased mammography screening that year, and decreased thereafter. HRT use among all female members aged≥45 years decreased from 13.2% in 2002 to 4.6% in 2014, consistent with the global trend after the Women's Health Initiative publication. Analysis by BC subtype involved 6,218 invasive BC patients diagnosed between 2007 and 2014 (luminal A, 47.5%; luminal B1 without human epidermal growth factor receptor 2 [HER2] over-expression, 25.7%; luminal B2 with HER2 over-expression, 7.7%; estrogen receptor [ER]-negative/HER2+, 4.9%; triple negative, 8.3%; unknown, 6.0%). Overall, 75-86% of patients across all subtypes did not have any HRT exposure vs 14-25% who were current users (within 1 year before the BC diagnosis), recent users (within 2-5 years), or past users ( > 5 years). Current and recent use of HRT was statistically significantly higher in luminal BC vs ER-negative tumors: rates in luminal A/B1/B2, 15.3%/12.1%/11.1% vs ER-negative HER2+/triple-negative/unknown, 8.9%/9.7%/7.7% ( P< 0.001). In BC patients (≥45 years) with HRT exposure, the preparations used were estrogen plus progesterone (62%), estrogen alone (24%), and tibolone (14%). In non-BC cases (≥45 years), the respective values were similar: 61%, 26%, and 13%. Conclusions: HRT current/recent exposure may contribute to increased incidence of luminal BC tumors.

scholarly journals Association Between Hormone Replacement Therapy and Development of Endometrial Cancer: Results From a Prospective US Cohort Study

2022 ◽  
Vol 8 ◽  
Author(s):  
Ying Liang ◽  
Haoyan Jiao ◽  
Lingbo Qu ◽  
Hao Liu
Keyword(s):  
Endometrial Cancer ◽  
Cohort Study ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Large Scale ◽  
Proportional Hazards ◽  
Hormone Replacement ◽  
Cox Proportional Hazards

Although hormone replacement therapy (HRT) use is associated with elevated endometrial cancer(EC) risk, little evidence assesses potential effect-modifiers on HRT-related EC in a long-term follow-up. In this large-scale longitudinal cohort study, we tried to evaluate the association between different HRT types/methods use and risk of EC, and reveal this risk within different body mass index (BMI) groups. In whole cohort, 677 EC occurred during mean 11.6 years follow-up. Cox proportional hazards regression was used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs) with HRT status (never, former, or current) for risk of EC incidence. Current HRT use was not significantly associated with EC risk (HR for current vs. never HRT use: 1.13; 95% CI: 0.92, 1.38) in the whole cohort, but presented a dose-response effect on increased EC risk (HR for &gt;10-year use vs. never HRT use: 1.73; 95% CI: 1.35, 2.21). Moreover, EC risk differed in distinct regimens or subsets (all Pinteraction &lt; 0.05). Estrogen-only use was associated with elevated EC risk (HR for current vs. never HRT use: 1.51; 95% CI: 1.12, 2.04), but women with high BMI (&gt; 30 kg/m2) who currently use estrogen-only harbored decreased EC risk (HR: 0.56; 95% CI: 0.38, 0.82) compared to counterparts without HRT use. Estrogen-only use is associated with increased EC risk, and precise monitoring of EC development for postmenopausal women with long-term HRT use are urgently needed. BMI could serve as an important surrogate to assess this risk.

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