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Deborah Grady, MD, MPH; Susan M. Rubin, MPH
University of California, San Francisco

JAMA. 1993;269(8):990.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—To help resolve the conflict in the literature regarding the association of postmenopausal hormone therapy and breast cancer, Henrich¹ reviewed three meta-analyses. We are concerned that the data reported in that article were incomplete, inaccurate, and misleading.

Two recently published meta-analyses are not included in this review.^2,3 The author correctly concludes that none of the meta-analyses (including the two that were not reviewed) found an increased risk of breast cancer associated with ever use of estrogen. The median duration of estrogen use is brief, generally about 2 years.⁴ Thus, risk estimates for women who ever used estrogen should really be interpreted as risk among short-term estrogen users. Since hormone replacement is now commonly prescribed for 10 to 20 years or more to prevent osteoporosis and heart disease, we must also ask if long-term estrogen use is associated with increased breast cancer risk.

The author . . . [Full Text PDF of this Article]

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