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To the Editor: The WHI investigators found that use of estrogen alone was associated with a lower risk of breast cancer,¹ while estrogen-plus-progestin was associated with an increased risk.² We found similar results in our large cohort study of 374 465 postmenopausal women conducted between 1996 and 2000 in community-based mammography practices.³ We found the risk of breast cancer among women using estrogen alone for less than 5 years, compared with women not using hormone therapy, was decreased 14% (95% CI, –29% to 3%) with 51 estrogen-only breast cancer cases. We found the risk of breast cancer among women using estrogen alone for more than 5 years, compared with women not using hormone therapy, was decreased 8% (95% CI, –16% to 0%) with 272 estrogen-only breast cancer cases. We also found the risk of breast cancer was increased 49% (95% CI, 36%-63%) among women using estrogen-plus-progestin for 5 years or more, . . . [Full Text of this Article]

Karla Kerlikowske, MD
kerliko@itsa.ucsf.edu
Veterans Affairs Medical Center
San Francisco, Calif

Diana L. Miglioretti, PhD
Center for Health Studies, Group Health Cooperative
Seattle, Wash

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