La controversia entre terapia de reemplazo con estrógenos y el riesgo de cáncer de mama en la menopausia / Controversy between estrogen replacement therapy and risk of breast cancer in menopause

RESUMO

At present, no information is available from controlled prospective randomized clinical trials to demonstrate a causal link between estrogen replacement therapy (HRT) and the risk of developing breast cancer. In most epidemiologic studies, HRT is not associated with an major increased risk of breast cancer; thus for women who had used estrogen for 10 years or more, the relative risk of breast cancer is 1.46 which is considered as small magnitude. Clinicians and patients are challenged with the difficult task of balancing the beneficial effects of HRT on cardiovascular and bone disease with the potential adverse effects on the breast. The analyses of the benefits and risks of HRT generally indicate that the benefits of therapy outweigh the risks. In other respect the number of survivors of breast cancer are increasing rapidly because of both early detection and the availability of more effective treatments. This effect will increase the number of hypoestrogenic survivors of breast cancer, a group that might benefit from HRT. However, the decision of using HRT has to be determined between the patient and the physician.