Breast cancer and Prempro revisited

A new study has kicked up the argument over hormone replacement therapy. Researchers revisited the medical records of women who participated in the now-infamous Women's Health Initiative study that NIH halted in 2002, warning that Wyeth's Prempro appeared to increase breast cancer, heart attacks and strokes. Their analysis found that patients assigned to take Prempro saw their additional breast cancer risk fall quickly after they stopped taking HRT, within about two years. That decline mirrored an overall decline in breast cancer rates in the U.S. and several other countries.

Ergo, the New England Journal of Medicine study states, the sudden drop in breast cancer diagnoses--to 190,000 in 2003 and thereafter in the U.S., from an average 210,000 before 2002--can be credited to the warning against overusing hormone replacement after menopause.

Predictably, these findings have stirred up controversy. Wyeth quickly questioned the conclusion that cancer dropped because hormone replacement dropped. It's an erroneous conclusion, Wyeth SVP Joseph Camardo told the Wall Street Journal. What about a coincident change in mammography rates? Besides, said one WHI critic, the drop in cancer rates was too fast to be a hormonal thing: "You don't see a decrease in six months," Dr. Avrum Bluming of the University of Southern California said.

The new study looked at changes in mammography usage and concluded they were unrelated. "These are non-conventional analyses, but I think this is the best data we have," the study's lead author said. "For two to a few more years, combined hormone therapy is safe." But after that, he said, women should stop. What say ye, Wyeth?

- read the WSJ story