Breast Cancer: Hormone Replacement Therapy and Cancer Risk乳腺癌：激素替代疗法与癌症的风险

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Friday, 28 December 2007星期五， 2007年12月28日

Hormone replacement therapy (HRT) is used to relieve menopause symptoms, especially hot flashes.激素替代疗法（ HRT ）是用来减轻更年期症状，尤其是潮热。 A woman on hormone therapy usually takes both estrogen and progestin (typically a synthetic form of progesterone).一个女人对激素治疗通常需要两雌，孕激素（通常是合成形式的黄体酮）。 Women who have had a hysterectomy can take estrogen alone.谁妇女有子宫切除术可采取单独雌激素。 Estrogen relieves hot flashes and prevents osteoporosis, but estrogen can increase your risk of developing uterine cancer.雌激素可以减轻潮热，并防止骨质疏松症，但雌激素可以增加您的风险，发展中国家子宫癌。 Progestin is added in women with a uterus to prevent this.孕激素是增加妇女的子宫，以防止这一点。

Many studies have looked at the association between hormone therapy and breast cancer.许多研究望着之间的关联激素疗法与乳腺癌。 The best evidence for the benefits and risks of hormone replacement therapy come from the Women's Health Initiative (WHI), a large study involving more than 16,000 healthy women.最好的证据，利益和风险的激素替代疗法来自妇女健康倡议（白盔倡议），大型研究涉及超过16000名健康女性。 The results published in July 2002 showed the risks of combined HRT with estrogen plus progestin outweigh the benefits.研究结果刊登在2002年7月发现的风险结合疗法与雌激素加孕得不偿失。 These risks include an increase in breast cancer, heart disease, stroke and blood clots.这些风险包括增加患乳腺癌，心脏病，中风和血液凝块。

Not only does combined HRT increase the risk of developing breast cancer, but it also increases the chances that the cancer will be discovered at a more advanced stage.不仅结合疗法增加患乳腺癌，但同时也增加了机会的癌症会发现一个更高级阶段。 This is due to its influence in reducing the effectiveness of mammography.这是由于其影响力在减少乳腺效力。

If a woman no longer has a uterus, estrogen alone can be given for symptoms of menopause.如果一个女人不再有子宫，雌激素就可以得到的更年期症状。 This probably does not increase the risk of developing breast cancer much, if at all.这大概不会增加患乳腺癌多，如果在所有。 In March 2004, it was concluded from the WHI study that those taking estrogen only had no increased risk of breast cancer or heart disease, however estrogen does appear to increase one's risk of stroke. 2004年3月，这是结束的白盔倡议，这些研究同时雌激素不仅不会增加患乳腺癌的风险或心脏病，但雌激素会出现增加人的中风危险。

If a woman is faced with menopause and hot flashes, she and her doctor should discuss the risks and benefits and decide if treatment should included hormone therapy or not.如果一个女人正面临着绝经期和潮热，她和她的医生应该讨论的风险和好处，并决定是否治疗应包括激素治疗或没有。

Do the Benefits of Hormone Therapy Outweigh the Risk?这样做的好处激素治疗大于风险？

Hormone therapy is an effective treatment for relieving hot flashes from menopause.激素疗法是一种有效的治疗，以纾缓潮热从更年期。 But the known link between hormone therapy and increased breast cancer risk has discouraged many women and their doctors from choosing or recommending this treatment.但众所周知之间的联系和激素治疗增加乳腺癌风险阻碍了许多妇女和他们的医生选择或建议这种待遇。

The type of hormone therapy (estrogen only or combination of estrogen and progestin), as well as the woman's individual characteristics, risk factors and severity of menopause symptoms, should be considered when weighing the risks and benefits of HRT.该类型的激素治疗（只雌激素或结合雌激素和黄体酮），以及妇女的个人特征，危险因素和严重更年期症状时，应考虑权衡风险和利益的停留时间。 The decision to use hormone therapy after menopause should be made by a woman and her healthcare provider after weighing all of the potential risks (including heart disease, breast cancer, stroke and blood clots) and benefits (relief of menopause symptoms and prevention of osteoporosis).决定使用激素治疗绝经后应当由一名妇女和她的医疗保健提供商权衡轻重后，所有的潜在风险（包括心脏病，乳腺癌，中风和血液凝块）和福利（救济的更年期症状和预防骨质疏松症）。

The known association between HRT and breast cancer has prevented many breast specialists from recommending it for breast cancer survivors.已知的关联性疗法与乳腺癌已使许多乳腺癌专家建议为乳腺癌幸存者。 Unfortunately, many women experience menopause symptoms after breast cancer treatment.不幸的是，许多妇女更年期症状的经验后，乳腺癌治疗。 Some forms of chemotherapy can also cause early menopause in premenopausal women.某些形式的化疗也可能导致绝经期提前在绝经前妇女。

In the past doctors had offered HRT after breast cancer treatment because there weren't clear cut studies showing any harm.在过去的医生提供了水力后乳腺癌的治疗，因为没有明确的研究显示任何伤害。 However, early in 2004, a study (the HABITS study) was stopped early after it was shown that cancer survivors on HRT were more likely to develop a new or recurrent breast cancer.然而，在2004年初，一份研究报告（研究的习惯）被截停后，早期研究表明，癌症幸存者的停留时间更可能开发一种新的或复发的乳腺癌。 Doctors now feel it may be too risky to treat breast cancer survivors with HRT.医生们现在认为，可能是过于冒险治疗乳腺癌幸存者与停留时间。

Alternative Options for Hormone Therapy to Protect your Bones From Osteoporosis替代选择激素治疗，以保护您的骨骼骨质疏松症

Selective estrogen receptor modulators (SERMs) are a newer class of drugs similar to estrogen that protect against osteoporosis by increasing bone density, while perhaps also protecting against the development of breast cancer.选择性雌激素受体调节剂（剂）是一种新的类药物类似雌激素，以保护对骨质疏松症的骨质密度增加，同时也可能对保护发展的乳腺癌。

Raloxifene (Evista) is a widely used SERM that has been shown to increase bone growth and density.雷洛昔芬（ Evista ）是一种广泛使用的剂已表明，增加骨骼的生长和密度。 Unfortunately it does not relieve symptoms of menopause, such as hot flashes and may actually worsen them.不幸的是它没有缓解更年期症状，如发热和实际上可能恶化他们。 Although the FDA has approved this drug for osteoporosis prevention, studies are currently being done to investigate its use in breast cancer prevention and treatment.尽管美国食品和药物管理局已批准这种药物对预防骨质疏松症的研究，目前正在做调查其使用在乳腺癌的预防和治疗。

Additional interventions that may prevent or treat osteoporosis include weight bearing exercises, other prescription medications and taking calcium and vitamin D supplements daily.更多的干预措施，可以防止或治疗骨质疏松症包括负重练习，其他处方药，并考虑钙和维生素D的补充每日。

Reviewed by the doctors at The Cleveland Clinic Taussig Cancer Center .审查由医生在克利夫兰诊所陶癌症研究中心。

WebMD Medical Reference provided in collaboration with the Cleveland Clinic中央社提供医学参考与克利夫兰诊所