Climacteric : the journal of the International Menopause Society
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To determine any association between hormonal replacement therapy (HRT) usage and breast cancer recurrence and survival rates in women who were premenopausal at the time of diagnosis of breast cancer. ⋯ HRT use in women who were premenopausal at the diagnosis of primary invasive breast cancer is not associated with worse outcomes in terms of breast cancer recurrence or mortality.
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Over 24-25 February 2003 in Funchal, Madeira, Novo Nordisk gathered together 25 of the top international hormone replacement therapy (HRT) experts, in order to debate the results of the Women's Health Initiative (WHI) and interpret its possible implications for the future use of HRT. The meeting covered many interesting and controversial areas, addressing the complex and multifaceted issues with insight and realism. Some of the areas covered at the meeting were the use of HRT as a short- or long-term therapy for hot flushes, for general menopausal symptom relief and in osteoporosis prevention; the overall risk-benefit profile and specific breast cancer concerns were also discussed. ⋯ Medroxyprogesterone acetate and norethisterone acetate have different pharmacokinetic profiles and different activities on steroid receptors. Evidence from preclinical and clinical studies supports the conclusion that these differences result in different pharmacological and clinical effects in favor of norethisterone acetate. Having comprehensively discussed and reviewed all available evidence, a consensus was achieved with regard to appropriate therapy: HRT should be given to women with menopausal complaints to meet their individual needs, taking into account their individual risk profile and the overall therapeutic objectives.
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To determine the risk of recurrence of breast cancer associated with the use of hormone replacement therapy (HRT) in the management of menopausal symptoms in women previously treated for breast cancer who were taking concurrent tamoxifen or who were estrogen receptor-positive. ⋯ The use of HRT was not associated with an increased risk of recurrence of breast cancer in women taking concurrent tamoxifen or who were estrogen receptor-positive.
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Sex steroids are not known to damage DNA directly. They can stimulate or inhibit cell proliferation, and thus can modulate tumor developmental progression. Sex steroid-related tumors in women are represented by breast cancer and endometrial cancer, and a possible relationship exists between sex steroids and both ovarian and colon cancer. ⋯ The available data do not allow to discriminate for all these variables and therefore it is inappropriate to consider jointly all forms of hormonal therapy. This issue is considered as an important area for future evaluation and research. The International Menopause Society is in the process of drawing up specific recommendations for further research in the field of HRT and cancer.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of different treatment modalities for postmenopausal patients with osteopenia: hormone replacement therapy, calcitonin and clodronate.
To evaluate the effectiveness of hormone replacement therapy (HRT), clodronate, calcitonin and a clodronate plus calcitonin combination in postmenopausal patients with osteopenia. ⋯ HRT was found to be the most effective treatment regimen in postmenopausal patients with osteopenia, compared with clodronate, calcitonin and a clodronate plus calcitonin combination. Clodronate or calcitonin might be alternatives when HRT is contraindicated or refused by the patient; although calcitonin was found to be less effective. The clodronate plus calcitonin combination was not superior to either of these agents when used alone.