Abstract
Breast cancer is the most common malignancy in women in the United Kingdom, and survival of women with a diagnosis of breast cancer is increasing due to early detection and adjuvant treatment. However, this improvement in prognosis is not necessarily associated with a good quality of life since many patients experience debilitating symptoms resulting from estrogen deficiency. The traditional view is that hormone replacement therapy (HRT) is contraindicated because of the fear of precipitating recurrence. Although endogenous risk factors are associated with the development of breast cancer, and ovarian ablation or medical hormone manipulation are effective treatments, there is unconvincing evidence to implicate the oral contraceptive pill and HRT in the pathogenesis of breast cancer. There is also very little evidence that a high endogenous estrogen level is associated with a poor prognosis in patients with breast cancer, and the small non-randomized studies to date have reported no adverse effects of HRT in women after the diagnosis of breast cancer. The time has come for this proscription to be reevaluated.
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