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Experts react to study linking drop in breast cancer rates in women who stopped HRT

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Dec. 18--Statistics from a major study revealing that rates of the most common form of breast cancer dropped dramatically between 2002 and 2003 are being greeted with applause and skepticism as the medical and advocacy communities digest the news.

The research, reported last week by medical investigators at M.D. Anderson Cancer Center in Houston, set an upbeat tone at the San Antonio Breast Cancer Symposium where the data were presented.

The research found the decline the most common form of the disease -- estrogen-receptor positive cancers, those whose growth is hormone-fueled.

An estimated 70 percent of all breast cancers are believed to be estrogen-receptor positive.

Hailed as stunning by many specialists at the meeting, the research offers a sense of hope about a disease that ranks as the second-leading cause of cancer deaths in women. Researchers attribute the decline to women having abruptly dropped their use of hormone replacement therapy -- HRT -- in August 2002. Results from a major Women's Health Initiative that month demonstrated HRT increased the likelihood of breast cancer, blood clots, heart attacks and stroke.

Dr. Peter Ravdin, a medical oncologist at M.D. Anderson, discovered a 7.2 percent decline in breast cancer incidence between August 2002 and December 2003. During the same period, he found a dramatic 12 percent drop in breast cancer incidence for those between ages 50 and 69.

Ravdin said 14,000 fewer women were diagnosed with breast cancer in 2003 than in 2002, a year in which the American Cancer Society estimated 203,500 new cases would be diagnosed in the United States.

"This is very good news," said Elsa Ford, president of the Brentwood/Bay Shore Breast Cancer Coalition. "It was so easy to embrace this treatment without close attention to potential side effects, especially on a long-term basis."

Hillary Rutter, director of the Adelphi New York Statewide Breast Cancer Hotline and Support Program in Garden City, also found the new research encouraging.

"A lot of women just went on it," Rutter said of HRT. "When the Women's Health Initiative came out, a lot of women said, 'Oh my God,' and millions of women stopped taking it. So it wasn't a coincidence that the rate went down."

Prempro, the combination estrogen-progestin hormone pill, was prescribed routinely to millions of women to abate symptoms of menopause. Wyeth Pharmaceuticals, Prempro's maker, found sales cut by half when results about HRT's dangers were revealed.

Still, Dr. Francis Arena, president of the Sass Foundation for Medical Research in Roslyn, questions the new study's findings. He thinks the decline Ravdin found should have been seen after a much longer period.

"This sounds too good to be true," Arena, a breast cancer specialist, said Friday. "It is very difficult to believe we're that lucky, and I believe in luck -- but I also believe in science."

Dr. Julia Smith, director of the NYU Cancer Institutes' Breast Cancer Screening and Prevention Program, also isn't ready to embrace the new research. "We believe that HRT contributes to hormone receptor positive cancers in post-menopausal women, but it's hard to believe that HRT would play the sole role in such a significant decline.

"The study only looks at one year, so HRT may be one factor. Further study is necessary to see if this drop is a trend, a blip, or if other factors played a role," she said.

"What irked me previously was how many doctors were putting women on HRT -- even my own mother, and she had no [menopausal] symptoms," Rutter said.


Copyright (c) 2006, Newsday, Melville, N.Y.

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