Marsden Jo
King's College Hospital NHS Foundation Trust, London, UK.
Post Reprod Health. 2019 Mar;25(1):33-37. doi: 10.1177/2053369119825716. Epub 2019 Feb 16.
In women at population risk of breast cancer (i.e. most), short-term exposure to hormone replacement therapy (i.e. up to five years' use) for symptom relief exceeds its potential harms, including the associated, increased risk of breast cancer diagnosis. Many women and health care professionals, however, consider this to be unacceptably high, although the degree of risk conferred appears equivalent to, or less than that of, other lifestyle risk factors for this condition. In contrast, it is recommended that symptomatic women at high baseline risk due to a family history or a biopsy-confirmed high-risk benign breast condition and those with previous breast cancer should be managed initially with lifestyle changes and non-hormonal alternatives. In a minority, whose symptoms are refractory, hormone replacement therapy and or topical estrogen can be considered but prescription should only take place after a discussion between the patient, her primary health care and breast specialist teams.
在有患乳腺癌风险的女性群体中(即大多数女性),短期使用激素替代疗法(即使用时间长达五年)来缓解症状,其益处超过了潜在危害,包括与之相关的乳腺癌诊断风险增加。然而,许多女性和医疗保健专业人员认为这种风险高得令人无法接受,尽管这种风险程度似乎等同于或低于该疾病的其他生活方式风险因素。相比之下,对于因家族病史或活检确诊的高危良性乳腺疾病而处于高基线风险的有症状女性以及曾患乳腺癌的女性,建议首先通过改变生活方式和采用非激素替代方法进行处理。对于少数症状难治的女性,可以考虑激素替代疗法和/或局部雌激素,但只有在患者与其初级医疗保健团队和乳腺专科团队进行讨论后才能开出处方。