THERE is a definite need for a safe estrogen supplement for women who are at risk of breast or endometrial carcinoma but who are denied such therapy because of recent evidence that exogenous estrogen can induce carcinoma in susceptible women. The role of supplemental estrogen in the induction of carcinoma is controversial, but the consensus is that high risk contraindicates its use.1
Who are the women considered to be at risk? A list of risk factors in approximate descending order of importance would be as follows: (1) previous carcinoma of breast or endometrium, with apparent long-term "cures" or better stated, "arrests," (2) designated precancerous lesions combined with a strong family history of carcinoma of the breast, (3) breast-biopsy findings of a precancerous lesion such as ductal proliferation and cellular atypia, (4) mammography findings of increased density and asymmetrical density, prominent ductal pattern, diffuse punctate calcifications, and other
Follingstad AH. Estriol, the Forgotten Estrogen? JAMA. 1978;239(1):29–30. doi:10.1001/jama.1978.03280280029018
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