Estrogen and Your Breast Cancer Risk

Estrogen is probably the hardest-working hormone in a woman’s body, but

it also has a dark side: Research has determined that estrogen often plays
a key role in the development of breast cancer, especially after a woman
reaches menopause. How? The estrogen in a woman’s body seems to
raise breast cancer risk by encouraging the growth of breast tissue, which
can speed up an existing tumor’s growth. Here's what you need to know.

• Combination hormone therapy (HT): If you’re considering taking

estrogen and progestin (a synthetic form of the hormone progesterone) to
give you relief from annoying menopause symptoms like hot flashes and
night sweats, be sure to limit the time you’re on the drugs. That’s because
over time your breast cancer risk climbs, says JoAnn Manson, MD,
professor of medicine at Harvard Medical School and author of Hot
Flashes, Hormones & Your Health.

"In the Women’s Health Initiative (WHI) trial, when women got seven years
of estrogen alone, there was no increased risk of breast cancer, but after
four to five years on combined hormone therapy, the risk emerges," she
says. In fact, over time, estrogen plus progestin can raise a woman’s risk
for breast cancer by 24%; even if you take estrogen on its own for more
than 10 to 15 years, your risk may still go up.

Dr. Manson was a coauthor on a March 2008 study in the Journal of the
American Medical Association that followed up on the WHI trial. It showed
that even after the women stopped taking combination HT, their breast
cancer risk remained elevated. "The risk of breast cancer does decline
after stopping hormone therapy," she stresses, "but if a tumor has formed
while a woman is on hormones it’s very likely to come to light even after
she stops hormones, so there is some residual risk. Stopping drug therapy
doesn’t mean a tumor evaporates, but the risk gradually declines."

• HT and early diagnosis of breast cancer: If you have no family history of

the disease, you’ve probably been encouraged to get your first
mammogram by age 40 and every one to two years after that to help
ensure that any tumor is caught early, when it’s most treatable. That’s
good advice, but taking HT may complicate things. "Estrogen-and-
progestin HT can lead to increased mammographic density"—denser
breast tissue—"that can obscure breast tumors and delay diagnosis," says
Dr. Manson. Denser breasts are believed to be an independent risk factor
for breast cancer, but they also make it harder to accurately read a
mammogram and that "can lead to abnormal mammograms that may
require extensive follow-up and anxiety about repeat testing and even
unnecessary biopsies," Dr. Manson adds.

• HT and risk for benign breast disease: In April 2008, the Journal of the
National Cancer Institute found that postmenopausal women who’d taken
estrogen on its own doubled their risk of a noncancerous type of breast
disease, but one that’s associated with a higher risk of breast cancer. A
September 2008 study led by the same author, Thomas E. Rohan, MD,
PhD, an epidemiologist at the Albert Einstein College of Medicine, in New
York City, found similarly disturbing evidence in a study of women taking
estrogen and progestin: Combined HT raised a woman’s risk of benign
breast disease by 74%.

http://www.health.com/health/condition-
article/0,,20250049,00.html
 Baby Boomers and Stroke Risk

“When does your risk for stroke increase?”

The American Stroke Association asked this question, and found that most
baby boomers consistently gave the wrong answer, predicting that stroke
risk increases at an age that was much older than their own.

The correct answer is that the risk of stroke begins to double at age 55.
Maybe they were just hoping “It will never happen to me.” Even those
people 55 or older believed that their risk for stroke didn’t increase until
sometime in the distant future. It’s a dangerous belief.

The truth is that there are many risk factors for stroke. Some cannot be
controlled – such as age and gender (men have a higher risk of stroke than
women). Some can be controlled, such as blood pressure, weight, and to
some extent cardiovascular health. One way to reduce the risk of stroke is
to work on those things that can be controlled.

High blood pressure and high cholesterol can be reduced with prescription
medications, but may come with unpleasant side effects. Fortunately,
more doctors have become aware of the benefits of nutritional
supplements. As more and more research is published in medical journals
about the effectiveness of Essential Fatty Aids for controlling blood
pressure and cholesterol, doctors are welcoming the idea of
recommending these products for some of their patients.

Other nutrients may receive less press coverage, because not many
clinical trials have been performed on them, but Coenzyme Q-10 is also a
heart-healthy supplement, and lesser known nutrients such as Tocotrienols
work closely with Vitamin E to provide even greater antioxidant benefits
for the heart.

Baby Boomers can take control of their health and wellness by being
aware of increased health risks naturally associated with growing older,
and taking some simple steps that may lead to a happy and healthy
future.

http://www.biometics.com/article.asp?id=483
 Women With Breast Cancer Gene Favor Preventive Mastectomy

MONDAY, March 9 (HealthDay News) -- Women who know they carry a

gene that puts them at higher risk of breast cancer tend to opt for
preventive mastectomy, a new study concludes.

Several type of risk management strategies are available to women found

to have a mutated BRCA1 or BRCA2 gene, which is known to elevate a
woman's risk of breast cancer. These range from simply having more
frequent screening exams to the preemptive removal of a breast.

Researchers at the University of Texas M. D. Anderson Cancer Center in

Houston interviewed women who were tested for the mutation. They
researchers found that roughly two-thirds of women who tested positive
for the BRCA mutation believed that a preventive mastectomy was the
most effective way to prevent breast cancer from developing or reduce
their worry about the disease.

Only 40% of women who tested negative for the mutation saw the surgery
as the best preventative and only a third thought the procedure was the
best way to alleviate their worry about having breast cancer.

"Health care providers and genetic counselors must take this into account
when assessing a woman's needs at the time of genetic testing and
results disclosure," the authors wrote in the April 15 issue of Cancer.

The researchers found that 81% of women who saw preventive

mastectomy as the best way to reduce cancer risk ended up having the
procedure after testing positive. Slightly more (84.2%) had the surgery if
they viewed it as the only way to reduce worry about possible breast
cancer.

-- Kevin McKeever

http://www.medicinenet.com/script/main/art.asp?articlekey=9835
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