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Hormone Replacement Therapy in Breast Cancer Survivors (1997)

Decker, David A. ; Pettinga, Jane E. ; Cox, Timothy C. ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

The @breast journal 3 (1997), S. 0

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ISSN: 1524-4741

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Abstract: The use of hormone replacement therapy (HRT) in postmenopausal breast cancer survivors is controversial. This report describes the symptomatic benefit of HRT and the subsequent risk of recurrent breast cancer in a group of postmenopausal women with a prior history of locally treated breast cancer.One-hundred and fourteen disease-free patients received HRT to control estrogen deficiency problems after local breast cancer therapy. Thirty-three had American Joint Committee on Cancer (AJCC) stage O at diagnosis, 43 stage 1, 24 stage 2A, 12 stage 2B, 1 stage 3A, and 1 stage 3B. Pathology was infiltrating carcinoma in 81, ductal carcinoma in situ (DCIS) 29, and lobular carcinoma in situ 4. Fifty-six were receiving HRT at the time of breast cancer diagnosis with 20 continuing HRT. One-hundred and eight patients received either an estrogen or an estrogen/progestin combination with 6 receiving vaginal estrogens. The time from breast cancer diagnosis to initiation of HRT ranged from .0 to 23.9, mean 3.7 years. HRT was administered for hot flashes in 77%, dyspareunia/vaginal dryness 53.5%, reactive depression/anxiety 34%. The duration of replacement therapy ranged from .10–17.5, mean 2.5 years.Hot flashes were relieved in 98%, dyspareunia/vaginal dryness 95%, and reactive depression/anxiety 95%. One new primary or ipsilateral breast recurrence (DCIS with microinvasion) 1.8%, (1/56, 95% confidence interval [Cl], .045–9.6%) was observed. One patient developed DCIS within breast tissue left on the chest wall after a modified mastectomy. Two new contralateral primaries, 2.0%, (2/103, 95% Cl, .24-6.8%) were observed. One occurred in the contralateral breast during therapy for an ipsilateral chest wall and systemic recurrence. Three patients, 3.0% (3/114, 95% Cl, .55–7.5%) have experienced systemic relapse with two deaths.In this selected group of postmenopausal women survivors, HRT dramatically relieved estrogen deficiency symptoms and did not appear to increase the risk of an ipsilateral, contralateral, or systemic recurrence.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1524-4741.1997.tb00142.x

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Molecular defects of erythroid 5-aminolevulinate synthase in X-linked sideroblastic anemia (1995)

Bottomley, Sylvia S. ; May, Brian K. ; Cox, Timothy C. ; [et al.]

Springer

Journal of bioenergetics and biomembranes 27 (1995), S. 161-168

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ISSN: 1573-6881

Keywords: X-Linked sideroblastic anemia ; heme biosynthesis ; erythroid 5-aminolevulinate synthase ; nucleotide substitution ; pyridoxine-responsive

Source: Springer Online Journal Archives 1860-2000

Topics: Biology , Chemistry and Pharmacology , Physics

Notes: Abstract The erythroid-specific isozyme of 5-aminolevulinate synthase (ALAS2), the first and ratelimiting enzyme of heme biosynthesis, is expressed concomitantly with the differentiation and maturation of the erythroid cell in order to accommodate generation of the large amounts of heme required for hemoglobin production. During the past few years the ALAS2 gene and its transcript have been characterized and the amino acid sequence of the enzyme deduced. The human genetic disorder X-linked sideroblastic anemia, previously postulated to be caused by defects of ALAS, has now been analyzed at the molecular and tissue-specific level. A heterogeneous group of point mutations in the catalytic domain of the ALAS2 enzyme has been found to cause the disorder. Impaired activity of recombinant mutant ALAS2 enzymes has also been demonstrated. Characterization of molecular defects in individuals with X-linked sideroblastic anemia has provided improved diagnosis for at-risk family members.