Studies On Estrogenreplacement Therapy In Breast Cancer Survivors

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DiSaia36 reported on 71 breast cancer survivors who received ERT. There was no exclusion based on time interval from diagnosis, stage, age, receptor status, or lymph node status. Women received combination therapy with progestin only if they had not previously undergone hysterectomy. Later, the author reported a comparison of 41 of these ERT survivors to 82 non-ERT breast cancer subjects, matched for both age and stage of disease.37 Survival analysis did not indicate a significant difference between the two groups. An updated series of 145 patients who received ERT for at least 3 months after diagnosis has identified 13 recurrences. The duration of estrogen use prior to the diagnosis of recurrent breast cancer ranged from 4 months to 11.5 years (Figures 15-1 and 15-2).

Other authors have reported their experience of ERT in breast cancer survivors. Eden38 reported six recurrences among 90 women receiving ERT. These ERT users were matched two to one with control subjects with no history of hormone use after diagnosis of breast cancer. The recurrence rate was 7 percent in the ERT users and 30 percent in the non-ERT users. Bluming39 reported on 155 breast cancer patients who received ERT for between 1 and 56 months, among whom 7 recurrences were identified. The only published prospective randomized trial is being undertaken by Vas-

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