Why does hormonal contraception and menopausal hormonal treatment have such a small effect on breast cancer risk?

Oestrogen is considered by many to be a major cause of breast cancer, and yet hormonal contraception and menopausal hormonal therapy have a paradoxically small effect on breast cancer risk. Also, in the oestrogen-only arm of the Women's Health Initiative, subjects given oestrogen had a reduced risk of breast cancer compared to controls. Initiation of breast cancer likely begins early in life, in the long-lived ERPR breast stem cell.

Menopausal status, adipose tissue, and breast cancer risk: impact of estrogen replacement therapy.

The seeds of breast cancer are likely sown in the first two or three decades of life. Rapid weight gain and height in infancy predict breast cancer risk in later life. The age at first pregnancy is also a strong predictor for breast cancer; the earlier the first full-term pregnancy, then the lower the risk of breast cancer in later life.

Phytoestrogens for menopausal symptoms: a review.

Objective: To review the evidence that isoflavones are effective treatments for menopausal symptoms and to present the safety data.

Methods: The databases Scopus, ScienceDirect and Primo Central Index were searched and preference was given to systematic reviews and meta-analyses.

Results: The available evidence suggests that isoflavones do not relieve menopausal vasomotor symptoms any better than placebo.

Breast cancer, stem cells and sex hormones. Part 3: the impact of the menopause and hormone replacement.

Breast stem cells are long-lived cells and so are exposed to carcinogenic influences for much longer than normal differentiated breast ductal cells. It is hypothesized that these stem cells are the major site of carcinogenesis within the breast. Epidemiological studies have suggested that early life events and early first pregnancy profoundly affect breast cancer risk in adult life.

Breast cancer, stem cells and sex hormones. Part 2: the impact of the reproductive years and pregnancy.

The primitive breast develops in utero and during infancy breast growth largely parallels the growth of the child. At puberty, the GnRH pulse generator starts up, initially with just 1-2 pulses daily. This results in very small amounts of unopposed estrogen being secreted by the ovary.

Human breast cancer stem cells and sex hormones--a narrative review.

Objective: The aim of this narrative review was to evaluate the role of cancer stem cells (CSCs) and sex steroids in the pathophysiology of human breast cancer.

Methods: A key-word search was performed using the Scopus database. Preference was given to studies using human cells and tissues.

Breast cancer, stem cells and sex hormones: part 1. The impact of fetal life and infancy.

Like other organs, the breast contains rare somatic stem cells (SCs) that are long-lived and slowly dividing. In the adult breast, they are closely regulated in areas located along the breast ducts called SC niches. Breast SCs can produce offspring that become ductal, alveoli or myoepithelial cells.

Why does oestrogen-only hormone therapy have such a small impact on breast cancer risk? A hypothesis.

There seems to be irrefutable evidence that oestrogen is involved in the pathogenesis of breast cancer. The disease mostly affects women and the epidemiology of breast cancer relates to reproductive markers such as pregnancy, age at menarche and age of menopause. Most breast cancers elaborate oestrogen receptors (ER) and in such cases endocrine therapies such as tamoxifen and aromatase-inhibitors (AIs) are effective adjuvant treatments.

The menopausal experience of Greek women living in Sydney.

Objective: This study was undertaken to investigate the menopausal experience of Greek women as part of a wider survey of four immigrant groups living in Sydney, Australia (the others being Indian, Arabic, and Chinese) and to examine the relationship between common symptoms and various sociodemographic factors.

Design: A total of 217 women were interviewed about their menopausal experiences by experienced health workers using the 29-item Menopause-Specific Quality of Life questionnaire.

Results: A total of 217 women participated in the survey.

Three cases of endometrial cancer associated with "bioidentical" hormone replacement therapy.

We describe three women who developed endometrial cancer after taking "bioidentical" hormone replacement therapy (HRT) to relieve menopausal symptoms. Although pharmaceutical HRT is a well established and tested therapy, little is known about the quality control, safety and efficacy of bioidentical HRT. Women should be advised to avoid bioidentical HRT, and those who continue to use it should receive regular endometrial surveillance.

Effect of a ginger extract on pregnancy-induced nausea: a randomised controlled trial.

Objective: To investigate the effect of a ginger extract (EV.EXT35) on the symptoms of morning sickness.

Design: Double-blind randomised placebo-controlled trial.

Transdermal progesterone and its effect on vasomotor symptoms, blood lipid levels, bone metabolic markers, moods, and quality of life for postmenopausal women.

Objective: To determine whether transdermal progesterone cream has any effect on vasomotor symptoms, mood, sexual response, cardiovascular lipid levels, or bone mineral metabolic markers.

Design: A parallel, double-blind, randomized, placebo-controlled trial comparing the effect of a transdermal cream containing a progesterone (32 mg daily) with a placebo cream. Eighty postmenopausal women in the Menopause Centre at the Royal Hospital for Women, Sydney, were randomly allocated to receive either the progesterone cream or the placebo.

A systematic review of the reproductive system effects of metformin in patients with polycystic ovary syndrome.

Objective: To review the effectiveness of metformin in restoring regular menstrual cycles and ovulation and achieving pregnancy in women with polycystic ovary syndrome (PCOS).

Design: Systematic review of pertinent studies identified using the bibliographic databases MEDLINE and EMBASE. References of selected articles identified were hand-searched for additional relevant citations.

Hormone replacement therapy after a diagnosis of breast cancer: cancer recurrence and mortality.

Objective: To determine whether hormone replacement therapy (HRT) after treatment for breast cancer is associated with increased risk of recurrence and mortality.

Design: Retrospective observational study.

Participants And Setting: Postmenopausal women diagnosed with breast cancer and treated by five Sydney doctors between 1964 and 1999.