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Jane A. Cauley, DrPH; Lewis H. Kuller, MD, DrPH
University of Pittsburgh Pittsburgh, Pa

JAMA. 1997;277(19):1516.

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

In Reply.

—We thank Dr Atkins for his clarification of our report of bone mineral density (BMD) and breast cancer. Dr Atkins is correct in his interpretation. We believe that the risk/benefit ratio for estrogen replacement therapy (ERT) needs to be reevaluated with respect to BMD, osteoporosis, breast cancer, and coronary heart disease. In our previous analysis of the determinants of ERT, we found that a history of osteoporosis or spine fracture was a primary determinant of ERT—in particular, continued long-term ERT.¹ Hence, women who are long-term users of ERT are more likely to have osteoporosis and, by inference, lower BMD and lower risk of breast cancer. . . . [Full Text PDF of this Article]

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