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© 2005 Oxford University Press
BRIEF COMMUNICATION |
Menopausal Hormone Therapy After Breast Cancer: The Stockholm Randomized Trial
on Behalf of the Stockholm Breast Cancer Study Group
Affiliations of authors: Department of Oncology (EVS) and Department of Medicine/Huddinge (LER), Karolinska University Hospital & Institute, Stockholm, Sweden
Correspondence to: Eva von Schoultz, PhD, Dept. of Oncology, Radiumhemmet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden (e-mail: eva.vonschoultz{at}karolinska.se).
In 1997 two independent randomized clinical trials, Hormonal Replacement Therapy After Breast Cancer—Is It Safe? (HABITS; 434 patients) and the Stockholm trial (378 patients), were initiated in Sweden to compare menopausal hormone therapy with no menopausal hormone therapy after diagnosis of early-stage breast cancer. Much of the design of both studies was similar; however, a goal of the Stockholm protocol, not shared with the HABITS trial, was to minimize the use of progestogen combined with estrogen. The HABITS trial was prematurely stopped in December 2003, because, at a median follow-up of 2.1 years, the risk for recurrence of breast cancer among patients receiving menopausal hormone therapy was statistically significantly higher (relative hazard [RH] = 3.3, 95% confidence interval [CI] = 1.5 to 7.4) than among those receiving no treatment. In the Stockholm trial, however, at a median follow-up of 4.1 years, the risk of breast cancer recurrence was not associated with menopausal hormone therapy (RH = 0.82, 95% CI = 0.35 to 1.9). Statistically significant heterogeneity in the rate of recurrence was observed (P = .02; two-sided likelihood-ratio test) between the two studies, indicating that chance may not be the only explanation. Doses of estrogen and progestogen and treatment regimens for menopausal hormone therapy may be associated with the recurrence of breast cancer.
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Editorial about this Article
- Progestins and Recurrence in Breast Cancer Survivors
- Rowan T. Chlebowski and Garnet L. Anderson
J Natl Cancer Inst 2005 97: 471-472.[Extract] [Full Text] [PDF]
Related Memo to the Media
- Press Release: Studies Examine Menopausal Hormone Therapy and Risk of Breast Cancer Recurrence
- Sarah L. Zielinski
J Natl Cancer Inst 2005 97: 467.[Extract] [Full Text]
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