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Article
August 17, 1994

Estrogen Replacement Therapy in Breast Cancer SurvivorsA Time for Change

Author Affiliations

Hematology-Oncology Associates, Denver, Colo; Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill; The Johns Hopkins Oncology Center, Baltimore, Md; Dana Farber Cancer Institute, Boston, Mass; University of Wisconsin-Madison; Fox Chase Cancer Center, Philadelphia, Pa; Denver Colo; Emory University School of Medicine, Atlanta, Ga; Northwestern University, Chicago, Ill; Indiana University, Indianapolis; Sylvester Comprehensive Caner Center, Miami, Fla; Fairfax Oncology Associates, Annandale, Va; Albert Einstein Cancer Center, New York, NY; H. Lee Moffitt Cancer Center, Tampa, Fla; ECOG Operations Office, Denver, Colo.
From the Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill (Dr Coblaigh); Hematology-Oncology Associates, Denver, Colo (Dr Berris); The Johns Hopkins School of Hygiene and Public Health (Dr Bush), and The Johns Hopkins Oncology Center (Dr Davidson), Baltimore, Md; Fairfax Oncology Associates, Annandale, Va (Dr Robert); Albert Einstein Cancer Center, New York, NY (Dr Sparano); Eastern Cooperative Oncology Group Operations Office, Denver, Colo (Dr Tormey); and Emory University School of Medicine, Atlanta, Ga (Mr Wood).

JAMA. 1994;272(7):540-545. doi:10.1001/jama.1994.03520070060039
Abstract

POSTMENOPAUSAL women often experience annoying and sometimes debilitating menopausal symptoms, and breast cancer survivors are no exception. Hot flashes, dyspareunia, atrophic vaginitis with attendant urinary tract symptoms, sleep disturbance, and mood change are among these symptoms. Coronary artery disease and osteoporosis may be more insidious, but potentially fatal consequences of menopausal estrogen decline. Estrogen replacement therapy (ERT) has been shown to ameliorate these problems,1,2 and as informed consumers, breast cancer survivors are increasingly inquiring about and/or requesting ERT.3

There are more breast cancer survivors alive now than ever before, so their nononcologic health problems are a growing concern. A dramatic rise in the incidence rates of breast cancer occurred in the United States between 1982 and 1987, presumably because of increased screening.4 The incidence of noninvasive and of small, invasive, axillary nodenegative breast cancers rose concurrently.4 Five-year survival rates for breast cancer patients also have been

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