While women with breast cancer who have used hormone-replacement therapy are known to have better survival odds than those whove never taken hormones, the advantage is due, most likely, to more-frequent mammography screening rather than the effect of the hormones on tumor biology, according to new findings by researchers at Fred Hutchinson Cancer Research Center.
"Most of the good prognostic factors that have been ascribed to HRT - such as smaller tumor size and earlier cancer stage at diagnosis - may simply be an artifact of screening," said Janet Daling, Ph.D., lead author of the paper, which appears in the current (November) issue of Cancer Epidemiology, Biomarkers and Prevention.
"In many cases probably the HRT itself is doing nothing, other than getting women to the doctor once a year for a prescription renewal - and a mammogram," said Daling, a member of Fred Hutchinsons Public Health Sciences Division. Daling and co-authors from five study sites nationwide reported that 90 percent of women who used combination estrogen/progestin HRT had undergone a screening mammogram within two years of breast-cancer diagnosis. In contrast, only 65 percent of women with breast cancer whod never used HRT had undergone a mammogram during that time period.
The National Institute of Child Health and Human Development and the National Cancer Institute funded the study. The women in the study were identified through the Surveillance, Epidemiology and End Results, or SEER, program, a national cancer registry operated by the National Cancer Institute. The Centers for Disease Control and Prevention served as the studys data-coordinating center. Study sites were located at the CDC (Atlanta), Wayne State University (Detroit), University of Southern California (Los Angeles), University of Pennsylvania (Philadelphia) and Fred Hutchinson (Seattle).
The Fred Hutchinson Cancer Research Center, home of two Nobel laureates, is an independent, nonprofit research institution dedicated to the development and advancement of biomedical technology to eliminate cancer and other potentially fatal diseases. Fred Hutchinson receives more funding from the National Institutes of Health than any other independent U.S. research center. Recognized internationally for its pioneering work in bone-marrow transplantation, the centers four scientific divisions collaborate to form a unique environment for conducting basic and applied science. Fred Hutchinson, in collaboration with its clinical partners, the University of Washington Academic Medical Center and Childrens Hospital and Regional Medical Center, is the only National Cancer Institute-designated comprehensive cancer center in the Pacific Northwest and is one of 39 nationwide. For more information, visit the centers Web site at http://www.fhcrc.org.
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