DÄ internationalArchive46/2008Decline in Hormone Replacement Prescription and Fall in Breast Cancer Incidence – An Epidemiologic Discussion: Pointed Comment

Correspondence

Decline in Hormone Replacement Prescription and Fall in Breast Cancer Incidence – An Epidemiologic Discussion: Pointed Comment

Dtsch Arztebl Int 2008; 105(46): 808. DOI: 10.3238/arztebl.2008.0808a

Neumann, J L

LNSLNS The author deserves thanks for his well worded, cautious epidemiological assessment of the coincidences mentioned.

In the course of discussing pros and cons in the light of many cited references, however, a potential—albeit small—risk increase has somehow escaped attention. Interested parties can find lists in many other places that clarify the known causes for a correspondingly higher incidence of breast cancer.

Hence my pointed comment: As long as the cited epidemiological studies about any comprehensive tumor registries do not consider changes in weight, age at menarche, number of children, duration of breast feeding, alcohol consumption, and age at menopause in women with breast cancer over the years, even subtle interpretations of the "hazards of HRT" are only a crime against trees—the printed paper used to perpetuate such an amount of one-eyed theories is not balanced out by the amount of information conveyed.

Applying US statistics in isolation to small–scale German circumstances is not helpful either if the baseline conditions do not fit: the substances used for HRT in the two countries are fundamentally different. Other countries' divergent observations only confirm the observations of endocrinology experts: we cannot assume simple group effects for therapy with sex hormones.

In terms of tumor biology, declines in the incidence rates of breast cancer within 2 years after stopping HRT are unlikely.

I hope that all further authors will pay heed to your recommendation and wait a few years!
DOI: 10.3238/arztebl.2008.808a

Dr. med. Joerg L. Neumann
Grambeker Weg 86
23879 Mölln, Germany