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Annals of Oncology 2:709-717, 1991
© 1991 European Society for Medical Oncology

review-article

A clinical dilemma: Estrogen replacement therapy in postmenopausal women with a background of primary breast cancer

R. L. Theriault and R. V. Sellin

Breast Medical Oncology Section, Department of Medical Oncology, The University of Texas, M.D. Anderson Cancer Center Houston, Texas, U.S.A.

Correspondence to: Dr. Richard L. Theriault Department of Medical Oncology The University of Texas, M.D. Anderson Cancer Center Box 95, 1515 Holcombe Boulevard, Houston, Texas 77030, U.S.A.

It is common practice to forego the prescribing of estrogen replacement therapy (ERT) for patients with a history of breast cancer. The consequences of estrogen deprivation particularly cardiovascular morbidity and osteoporosis are reviewed in the context of the potential risks of ERT in patients with prior breast cancer. The published data regarding breast cancer risks with oral contraceptive use and ERT in healthy women is reviewed. The rationale for a clinical trial of ERT in breast cancer patients, the proposed appropriate patient group and positive end points for assessing benefit of ERT in the population are presented. Lack of reliable clinical data makes ERT in breast cancer patients an unresolved clinical dilemma.

breast cancer, estrogen replacement therapy, menopause, osteoporosis, cardiovascular disease, chemotherapy effects


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