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Annals of Oncology 12:301-310, 2001
© 2001 European Society for Medical Oncology

review-article

The role of hormone replacement therapy in women with a previous diagnosis of breast cancer and a review of possible alternatives

K. I. Pritchard

Division of Clinical Trials and Epidemiology, Toronto-Sunnybrook Regional Cancer Centre Toronto, Canada

Correspondence to:K. I. Pritchard, MD, Division of Clinical Trials and Epidemiology, Faculty of Medicine, University of Toronto, Toronto-Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5

Estrogen replacement therapy either with (HRT) or without (ERT) accompanying progesterone is routinely offered to well women at the time of menopause, in order to relieve vasomotor symptoms, (hot flashes), reduce urogenital atrophy and reduce the risks of cardiovascular disease, osteoporosis and perhaps colon cancer and Alzheimer's disease. It is generally felt however, that women with a previous diagnosis of breast cancer are not suitable candidates for such therapy since either estrogen or progesterone may be associated with an increased risk of cancer recurrence. There are however, a variety of approaches to menopausal therapy in such women. A careful history must first be taken in order to identify the symptoms or conditions of concern. Vasomotor symptoms can be reduced by the use of other medications such as the antidepressant venlafaxine (Effexor). Estring, a vaginal estrogen ring can be used to reduce genitourinary symptoms, with little systemic estrogen absorption. Osteoporosis can be prevented or treated with calcium supplements, exercise, improved diet, bisphosphonates and/or selective estrogen receptor modulators (SERMs) while cardiovascular risk can be reduced by diet and exercise, as well as the appropriate use of lipid lowering and antihypertensive medications.

breast cancer, cardiovascular, hot flashes, menopause, osteoporosis


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Home page
 The Annals of PharmacotherapyHome page
C. E Schober and N. T Ansani
Venlafaxine Hydrochloride for the Treatment of Hot Flashes
Ann. Pharmacother., November 1, 2003; 37(11): 1703 - 1707.
[Abstract] [Full Text] [PDF]


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