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By E. G. Snyderwine (auth.), Prof. Dr. med. Hans-Jörg Senn, Richard D. Gelber Ph.D, Prof. Dr. med. Aron Goldhirsch, Priv.-Doz. Dr. med. Beat Thürlimann (eds.)

This quantity offers an updated survey of present laboratory and, generally, scientific learn at the diagnostic and remedies in basic breast melanoma. The chapters derive from the invited specialist lectures offered on the sixth foreign convention on basic Breast melanoma held in St. Gallen, Switzerland, in February 1998. the global breast melanoma neighborhood has been eagerly anticipating this quantity and its consensus platform and suggestions. there is not any substitute to this assembly and publication within the box of adjuvant treatment of fundamental breast cancer.

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Cancer Inst 89:1110-1116 Psaty BM, Heckbert SR, Atkins D, Lemaitre R, Koepsell TD, Wahl PW, Siscovick DS, Wagner EH (1994) The risk of myocardial infarction associated with the combined use of estrogen and progestins in postmenopausal women. Arch Intern Med 154:1333-1339 Estrogen/Hormone Replacement Therapy and the Etiology of Breast Cancer 31 Sillero-Arenas M, Delgado-Rodriguez M, Rodigues-Canteras R, Bueno-Cavanillas A, GalvezVargas R (1992) Menopausal hormone replacement therapy and breast cancer: a metaanalysis.

Early results of this study have shown that all four of the ERT/HRT preparations increased HDL, decreased LDL, and reduced fibrinogen levels. The most dramatic positive effects were seen with premarin used alone, but the effects of premarin plus a cyclic micronized progestin were not significantly different from those of premarin alone in comparison to placebo. The PEPI trial was not significantly powered to measure actual cardiovascular endpoints. On the negative side, it is well known that ERT given alone is associated with an increased risk of endometrial cancer.

8 (Grady et al. 1992a). It is clear from observational studies that the risk of developing endometrial cancer increases Table 1. Relative risk (RR) of myocardial infarction between 1986 and 1990 in postmenopausal women in a health cooperative (Psaty et al. 22 Table 2. Relative risk of hospital admission for first myocardial infarction in all women in uppsala county, Sweden (Falkeborn et al. I. Pritchard with the dose and duration of estrogen replacement. It is less clear that the mortality from endometrial cancer increases with ERT, but it probably does, although to a lesser degree.

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