DEBORAH AMOS, Host:
But NPR's Richard Knox reports the questions have not gone away.
RICHARD KNOX: Almost five years ago, one of the largest studies ever on women's health came up with a blockbuster result. Women on hormone replacement therapy have a 26 percent higher risk of breast cancer, 29 percent more heart disease, and a 41 percent higher risk of stroke.
PETER RAVDIN: After those results were published in July of 2002, most women in the United States stopped talking hormone replacement therapy.
KNOX: In this week's New England Journal of Medicine, they're reporting breast cancer incidence for 2004, another nine percent drop.
RAVDIN: And so that allows us to see that the drop was not a one-year wonder. In fact, it was sustained into a second year.
KNOX: The breast cancer decline has leveled off, another sign it was probably related to the sudden drop in hormone therapy. But there's one big question. When a woman stops hormone therapy, does the tiny undetected tumor in her breast melt away or has its growth just been delayed?
RAVDIN: We think what's happening is that when she stopped the hormone replacement therapy, any small undetectable breast cancers that she might have actually would grow more slowly. And therefore, their appearance might be delayed. In fact for some women, we're hopeful that small undetectable breast cancers might actually cease growing altogether for very long periods of time.
KNOX: It will take at least five years to answer that question, Ravdin says. Meanwhile, Dr. JoAnn Manson says former hormone users shouldn't let their guard down. Manson is the leader of the Women's Health Initiative, the study that first linked hormone therapy to breast cancer.
JOANN MANSON: I don't think that women should assume that simply because they've stopped hormone therapy they're no longer at risk to breast cancer and don't need to be vigilant about mammograms and regular clinical breast exams.
KNOX: Dr. Bruce Ettinger has some advice. He's an expert on the subject at the University of California at San Francisco.
BRUCE ETTINGER: We now know that half of the usual amount of estrogen is really a very adequate dose for most women.
KNOX: Ettinger says the standard hormone dose reduces women's hot flashes from an average of 10 a day to two.
ETTINGER: When they get a half-strength estrogen, they get about a 65 percent reduction in hot flashes. So now they've gone down from 10 hot flashes a day to three or four. Well, that maybe quite enough.
KNOX: Richard Knox, NPR News.
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