Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: In contrast to their current
report, the WHI investigators1 previously
reported that the use of estrogen-plus-progestin increased the risk of breast
cancer.2 More than 40% of women who received
unopposed estrogen had had their ovaries removed. The ovaries continue to
produce hormones well after menopause, albeit at lower levels.3 Supplemental
estrogen after oophorectomy may be beneficial in that it helps replace physiological
levels, whereas extra estrogen given to women who already have physiologically
normal levels of estrogen, given their age, is additive and may be harmful.
Thus, the authors should have analyzed these 2 groups separately.
Meyer VF. Effects of Estrogen-Only Treatment in Postmenopausal Women. JAMA. 2004;292(6):683. doi:10.1001/jama.292.6.683-c