ESTROGEN REPLACEMENT THERAPY AFTER TREATMENT FOR LOCALIZED BREAST-CARCINOMA - PATIENT RESPONSES AND OPINIONS

BAGKGROUND. Women who reach menopause after receiving treatment for br east carcinoma have been advised to avoid estrogen replacement therapy (ERT), but the validity of this practice is being reappraised and the need for prospective studies is discussed. The likely response of pot ential participants to the tangible rather than theoretic option for E RT provides not only useful information for planning such studies but also important insights into the attitudes and expectations of breast cancer survivors. METHODS. Women with a history of localized breast ca rcinoma, potentially eligible for participation in this prospective ER T study, were interviewed in person or by telephone and were asked to consider participation in a prospective, randomized study of ERT. In a ddition, information was obtained regarding their disease stage, estro gen receptor (ER) status, age at diagnosis, age at interview, and elap sed time since cancer treatment. RESULTS. The authors contacted 555 wo men; 137 did not meet criteria for study participation. Among the 418 women eligible for the program, one-third indicated a lack of interest and cited travel, financial, or age considerations. One-third of the women were apprehensive about ERT risk and declined. Forty women (13%) were either already receiving ERT or were seeking a prescribing physi cian. Finally, 17% of the women enrolled in our study. There were no d ifferences among the groups with respect to disease stage, ER status, age at diagnosis and interview or time elapsed since cancer treatment. CONCLUSIONS. Women with a history of breast carcinoma harbor consider able reluctance regarding ERT for the management of menopausal health concerns. However, a significant minority have already opted for ERT a nd up to 20% may become participants in clinical programs. Plans for l arge scale trials of ERT in this subset of women require careful atten tion to patient attitudes and concerns. (C) 1996 American Cancer Socie ty.