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Presse Med. 1996 Feb 3;25(4):141-4.
Is it possible to give a hormonal replacement therapy to a post-menopausal woman with a past history of breast cancer? As estrogens exert a proliferative effect on mammary cells, it remains a controversial issue. Only few studies have been conducted, generally uncontrolled, and involving only a small number of women given short-duration treatment. The endocrinologic arguments are discussed here. Hormone replacement therapy must be replaced in a general discussion on the potential risks for the breast and uterus, and the beneficial effect on coronary heart disease, osteoporosis, and quality of life. The risks and benefits must be weighted for each woman. The circumstances of prescription of hormone replacement therapy, and of the antiestrogen tamoxifen, which has proven a beneficial effect as adjuvant therapy for the menopausal women with a early breast cancer, must be discussed. Some physicians propose a prospective clinical trial to give an answer. Another way could be improvement of our knowledge about the prognostic factors of breast cancer, and better identification of possible "hormonal independance".
对于有乳腺癌病史的绝经后女性，给予激素替代疗法是否可行？由于雌激素对乳腺细胞有增殖作用，这仍然是一个有争议的问题。仅进行了少数研究，这些研究通常没有对照，且只涉及少数接受短期治疗的女性。本文讨论了内分泌学方面的论据。激素替代疗法必须在关于对乳腺和子宫的潜在风险以及对冠心病、骨质疏松症和生活质量的有益影响的总体讨论中加以权衡。必须为每位女性权衡风险和益处。必须讨论激素替代疗法以及抗雌激素他莫昔芬的处方情况，他莫昔芬已被证明对患有早期乳腺癌的绝经后女性作为辅助治疗有有益效果。一些医生提议进行一项前瞻性临床试验以得出答案。另一种方法可能是增进我们对乳腺癌预后因素的了解，并更好地识别可能的“激素非依赖性”。
