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August 9, 2000

Estrogen-Progestin Replacement and Risk of Breast Cancer

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(6):691-694. doi:10.1001/jama.284.6.691

To the Editor: The relative risks (RRs) reported in the retrospective study by Dr Schairer and colleagues1 are too small to claim a causal relationship. The clinical significance of the minimally elevated RRs cannot be interpreted as excess or attributable risk without incidence data. Assuming a yearly RR of 0.12 and an annual breast cancer incidence of 1 case per 1000, only 12 additional cancers would be diagnosed each year for every 100,000 women treated with estrogen and progesterone. No additional breast cancer deaths would occur (Schairer et al2 previously confirmed improved breast cancer survival with HRT) while many cases of osteoporosis would be prevented each year.

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