Menopause hormones confirmed as contributor to breast cancer

For years, alert doctors and scientists have recommended that women avoid taking hormones at menopause because they increase the risk of breast cancer.  That risk was confirmed yet again last week when the Women's Health Initiative revealed at the San Antonio Breast Cancer Symposium new data from a recent study.  The study started almost a decade ago, and was revised in 2002, when doctors concluded they could not ethically maintain women on estrogen  and progestin pills, given the steeply increased risk of breast cancer and heart problems.  Researchers continue to follow the study subjects for additional data.

Sixteen thousand women were matched by demographic factors before one-half were randomly assigned to receive either Wyeth Labs hormone therapy or a placebo.  The women taking Prempro (estrogen) showed a 26% higher incidence of breast cancer and that study group was disbanded in 2002.

Researchers then tracked more than 15,000 of these women through 2005 and found a clear trend:  the risk of breast cancer rose for as long as hormone therapy was administered and began to decline as soon as it was discontinued.  At its peak, the risk of breast cancer was doubled for women taking estrogen.  Wyeth still contends that taking Prempro is a good choice for women with "moderate to severe menopausal symptoms".  Most experts who have no financial interest in the matter vehemently disagree.

Back in the early 90s, we filed a related malpractice case against a Cadillac surgeon who maintained the patient's hormone therapy throughout her initial breast cancer treatment.   Our expert, who had previously worked in the National Cancer Institute, testified that our client initially had a ninety-plus percent probability of 10-year survival, given the small size and early stage of her tumor.  Instead, she was afflicted with metastatic cancer throughout her body, including brain, lungs and liver, within three years.  In lay terms, our consultant testified that estrogen "fertilized" the cancerous cells.  The surgeon could not dispute that the standard of care required that he discontinue estrogen therapy through breast cancer treatment, so he and his insurer focused on the claim that we could not prove "causation".

The defendant surgeon's insurance company retained a physician from the Lombardi Cancer Institute in Washington, D.C.  This doctor was considered to be one of the world's foremost experts on the treatment and prevention of breast cancer.  This retained expert testified on Defendant's behalf that there was no scientific support for our position. 

The Defendant settled our claim a few months later, however, when we discovered and presented evidence that the Defendant's expert had testified five years earlier that prescribing Premarin to an another patient had resulted in her breast cancer metastasizing.  As with many malpractice experts, the Lombardi expert retained by the Defendant had not considered it unethical to defend another doctor with misleading opinion testimony that contradicted his scientific opinion.  We were fortunate in that we were able to identify prior testimony in a case so closely related that we could prove the unreliabilty of the doctor's testimony.  The current Engler Supreme Court has relied upon similar ambiguities and scientific imprecision to dismiss several Michigan malpractice cases where a breach of the standard of care has occurred, but where "causation" can be disputed.