Hormone therapy less risky after hysterectomy-study

CHICAGO, Apr 12 (Reuters) Estrogen-only hormone replacement therapy used to treat symptoms of menopause does not raise the risk of breast cancer for women who have had a hysterectomy, a study said.

The finding contrasts with the higher risk of breast cancer among menopausal women taking estrogen plus progestin -- a combination designed to protect against uterine cancer. In a hysterectomy all or part of the uterus is removed.

Hormone replacement therapy came under scrutiny when research called the Women's Health Initiative (WHI) study was terminated early, in February 2004, because of unexpected findings that women faced heightened risks of ailments including stroke, blood clots and breast cancer.

Since then, further analysis of the WHI study data and other studies have generated confusion about the risks and benefits of hormone replacement therapy.

''This new analysis does not alter the overall conclusion from the WHI that hormones, including estrogen-alone and estrogen plus progestin, should not be used for the prevention of chronic disease,'' said Dr Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute of the National Institutes of Health yesterday, which sponsored the WHI study.

''The findings still support current recommendations that hormone therapy should only be used to treat menopausal symptoms and should be used at the smallest effective dose for the shortest possible time,'' Nabel said.

Women were originally prescribed the hormones to quell hot flashes and other symptoms of menopause, but there were also indications the therapy lowered the risks of heart disease, bone loss and possibly other ailments.

After the WHI study was published, sales of Wyeth's leading hormone replacement drugs Premarin and Prempro fell dramatically.

Illustrating the conflicting findings, a study published in January on women younger than those in the WHI study concluded hormone therapy lowered their risk of heart disease compared to women not on the therapy.

The latest analysis, published in this week's Journal of the American Medical Association, covered nearly 11,000 women participating in the WHI study who had had a hysterectomy.

''There were fewer breast cancers diagnosed for women on the active study pills'' compared to those taking harmless sugar pills for comparison purposes, study author Marcia Stefanik of Stanford University said.

''However, when we looked at those tumurs, those tumurs were actually significantly larger, and there was a tendency for them to have spread to more lymph nodes,'' she said.

The women taking estrogen had slightly fewer breast cancers but they had more follow-up mammograms and biopsies performed.

The hormone tends to make breast tissue denser and therefore more difficult to detect tumurs.

REUTERS KD SP1010