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HRT Raises Risk of Lobular Breast Cancer
Date:1/16/2008

menopause?. "Nothing in this paper is new as far as I'm concerned. It doesn't change the current recommendations which are that we should use hormone therapy in 1) the lowest effective dose; 2) for the shortest period of time possible; and 3) consistent with patient treatment goals with reevaluation periodically."

Previous studies, namely the Women's Health Initiative (WHI), found that combined estrogen and progestin hormone replacement therapy increased the risk of breast cancer. Further studies have indicated that the risk is greater with lobular carcinoma than with ductal carcinoma, but these studies have not been definitive.

Lobular cancer develops in the areas of the breast that contain milk-producing glands and is more likely to be estrogen-receptor positive and therefore responsive to targeted treatments, resulting in an 11 percent lower risk of death when compared with its ductal counterpart.

Ductal cancer develops in the ducts that carry milk from the lobules to the nipple and is more difficult to detect.

The rates of both invasive lobular carcinoma (ILC) and invasive ductal-lobular cancer (IDLC) increased 52 percent and 96 percent, respectively, from 1987 to 1999 in the United States. Invasive ductal carcinoma (IDC) increased only 3 percent during the same period, according to the study.

Since the WHI results were announced in 2003 and 2004, HRT use has declined 38 percent to 68 percent in the United States. Nevertheless, some 57 million prescriptions for postmenopausal HRT are still filled each year, according to the study.

Li and colleagues looked at more than 1,500 postmenopausal women, 1,044 with breast cancer and 469 controls. Among the women with breast cancer, 324 had lobular cancer, 196 had mixed ductal-lobular cancer, and 524 had ductal cancer. The women were 55 to 74 years of age and had been diagnosed between 2000 and 2004.

Women currently using combined hormone therapy
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