The controversy of hormone-replacement therapy in breast cancer survivors.

PURPOSE/OBJECTIVES: To review literature about hormone-replacement therapy (HRT) for breast cancer survivors, including potential risks and benefits, long-term health outcomes, research directions, and nursing's role in counseling these patients.

DATA SOURCES

Journal articles, abstracts, text excerpts.

DATA SYNTHESIS

HRT after menopause delivers proven benefits, including decreased risk of cardiovascular disease and osteoporosis and improved quality of life (QOL). As more women survive breast cancer, health risks resulting from treatment-induced menopause must be considered. Breast cancer survivors traditionally have not been offered HRT out of fear of cancer reactivation. This prohibition is being reexamined as data accumulate about estrogen's benefits.

CONCLUSION

Further prospective research is needed to develop criteria for the prudent use of HRT after breast cancer.

IMPLICATIONS FOR NURSING PRACTICE

Nurses can develop standards for patient education about HRT options and, when they are prescribed, design appropriate tools to measure HRT's impact on QOL, symptom relief, and long-term health outcomes.