March 4, 2008.
Risk of Breast Cancer with HRT No Big Deal?

This week in JAMA data from the Women's Health Initiative was published showing that a risk of breast cancer persisted after discontinuation of hormone replacement therapy (HRT) for up to three years. The risk was 0.3% per year. One of the authors was quoted as saying "There is no reason for alarm. The absolute risk is of small magnitude." I thought that was pretty amazing. I mean does he know that prevention of heart attacks in men without heart disease with statins is on the order of about 0.5% per year? I don't see anyone saying that the benefit is "of small magnitude" for them? Instead if 4 out of 100 men on a statin have a heart attack versus 5 out of 100 on placebo they call it a 25% decrease in risk. That is the difference between absolute and relative risk reduction. In other words the power of marketing.



 September 27, 2007. 2:12 p.m.
 Researchers Trumpet Alcohol Link to Breast Cancer.

 I was driving in my car today when I heard a well known  
medical authority on the radio trumpet the fact that alcohol causes breast cancer.
 
"even one or two drinks can cause breast cancer, and it doesn't matter  
what type of alcohol." This smelled like another example of the  
medical media drumming out pseudo news, so I decided to check it out.  
I assumed this had to be related to a publication of a major trial in  
a major journal, so I looked up this week's New England Journal of Medicine  
but I couldn't find it. I did some more research on the internet, and  
it turns out that it was an announcement by Kaiser Permanente, not even  
a published study. The authors reported a 30% increase in risk for women who  
drank three or more drinks per day and said it was equal to smoking a pack of  
cigarettes a day. However the risk of breast cancer with smoking is not that well established.  
also the risk we are talking about is on the order of about 1% for moderate drinking, more that  
offset by the beneficial effects on heart disease and other disease.  
Overall it seems the findings are overblown and not news  
considering the fact that the literature is full of studies including  
the Women's Health Initiative showing that there is no risk with moderate consumption  
for premenopausal women, the risk is small for postmenopausal women and can be eliminated with adequate  
folate intake in the diet.  

So before you put down that glass of wine, relax, and have a salad.

 
J. Douglas Bremner, MD, author of Before You Take That Pill:
Why the Drug Industry May Be Bad for Your Health: Risks and Side Effects
You Won't Find on the Label of Commonly Prescribed Drugs, Vitamins, and Supplements

 To purchase Before You Take That Pill from Amazon.com click here.

Doug Bremner, MD, is a physician
and researcher in Atlanta GA
and author of Before You Take That Pill:
Why the Drug Industry May be
Bad for Your Health


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