Atypical Ductal Hyperplasia and Estrogen - Forum

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Atypical Ductal Hyperplasia and Estrogen - Ärzteforum

Post#1 »

Recently I was asked about hormone replacement therapy (HRT) for a 72 year old woman who underwent a breast biopsy 6 months ago revealing atypical ductal hyperplasia and lobular hyperplasia. She is a "vasculopath" - severe coronary, peripheral vascular and cerebrovascular disease, and her cardiologist and gynecologist are questioning whether there might be a cardiovascular benefit from estrogen replacement therapy. My questions are:

1. Is there any cardiovascular benefit from HRT in a 72 year old woman? I thought that one recent study showed that after 10 years, cardiovascular mortality was the same for women who received HRT and those who did not.

2. Is the presence of atypical hyperplasia a contraindication to HRT?

3. Would anyone recommend one of the new "designer" estrogens, such as Raloxifene, which may have a lower breast cancer risk?

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Re: Atypical Ductal Hyperplasia and Estrogen - Ärzteforum

Post#2 »

I think HRT would still be helpful at her age.

Raloxifene is being promoted as an aid to bone mass retention. I don't think it has been studied well re cardioprotection or else it doesn't have much cardioprotective qualities.

I would put her on HRT, but don't have any scientific basis to back this up on. It just seems to me that she has much more likelihood of dying from cardiovascular disease than she does of dying from breast cancer. Her life expectancy from her cardiovascular disease is probably under 5 years.

In most cases, HRT induced breast cancers are found early and treated at an early enough stage that they do not increase mortality very much. In this case, in particular, an HRT induced breast cancer should have much less effect on mortality than her severe cardiovascular disease.

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Re: Atypical Ductal Hyperplasia and Estrogen - Ärzteforum

Post#3 »

I can't answer your questions but have one for you. Just what are your colleagues expecting to achieve with this lady - unless its to see if you can make her rattle if shaken?

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