HRT and breast cancer link 'alarmist'

Menopause societyThe need to provide some sort of perspective in the debate on the link between hormone replacement therapy (HRT) and breast cancer in women in the wake of recent negative publicity was highlighted at a conference in Dublin last weekend.

Jo Marsden, consultant surgeon at the Breast Care Unit at King's College Hospital in London, said the findings of the controversial Women's Health Initiative and Million Women Studies were actually not significantly different from the findings of previous studies.

The difference, she said, was that they were presented to the healthcare profession, the media and the public in an "unnecessarily alarmist" way.

"I am not saying there is no risk of breast cancer associated with HRT, I couldn't back that up with evidence. I am saying there is a risk, but it's not universal and we need to provide some sort of perspective on the issue," she said.

Ms Marsden told the Irish Menopause Society's 12th Annual Symposium and agm in Dublin that even with further research, many questions about breast cancer and HRT would remain unanswered, and if healthcare professionals were going to inform women properly, they had to be prepared to tackle these uncertainties.

"We shouldn't underestimate the ability of women to weigh up difficult information," said Ms Marsden.

"We must sit down with them and explain the risks involved and help them to weigh up the choices."

Ms Marsden pointed out that HRT was the most efficacious treatment available for the symptoms of menopause and oestrogen-deficiency problems in breast cancer patients, such as night sweats, hot flushes and sexual dysfunction.

"Most women treated for breast cancer will live to a normal or near normal life expectancy so quality of life issues are very important.

"Some women feel a good quality of life is important enough that they can cope with the uncertainties of using HRT and the possible risk of recurrence."

Ms Marsden said the media had been blamed for the negative publicity that HRT had received over the past few years, but she believed the blame lay with the researchers themselves for the way in which they presented their findings.

She said that women who were post-menopausal and overweight and women who had a high consumption of alcohol had a greater risk of developing breast cancer than women who took HRT, but this information was rarely publicised.

Dr Kieran Daly, consultant cardiologist at University College Hospital Galway, told the conference that preventative cardiovascular programmes must target women as aggressively as men. He also highlighted the need to clear up the misconception that cardiac disease was not as serious a problem in women as it was in men.

He said that cardiac disease was less easy to diagnose in women, but it tended to be more severe when it occurred.

As many as 63 per cent of women who died from cardiac disease had no previous symptoms and 42 per cent of women versus 24 per cent of men died within one year of suffering a heart attack.