Treatment of Estrogen Deficiency Symptoms in Women Surviving Breast Cancer

ProblemSeveral million women worldwide have survived breast cancer but are currently advised against the use of estrogen for management of menopausal symptoms and for prevention of early cardiovascular death and osteoporosis. Consensus ConferenceThe Consensus Conference, convened to address this problem at the Boar's Head Inn, Charlottesville, Virginia, September 21-23, 1997, was a unique meeting involving international experts and breast cancer survivors. RecommendationsRecommendations of the conference are summarized as follows:• Apply "tailored treatment strategies" to individual patients' needs.These strategies would avoid the use of estrogen while providing its benefits (short-and long-term).• Establish research trials to evaluate the use of estrogens or estrogen alternatives in selected groups of women in whom benefits might potentially outweigh risks.• Conduct clinical trials to exploit the highly favorable properties of selective estrogen receptor modulators (SERMs).• Forge a "Partnership for Progress" between patient advocate groups and health professionals to facilitate research and education about treatment options.• Develop further the "Partnership for Progress" by exploring the establishment of a patient-initiated registry to determine what alternatives or standard medical approaches patients are using to manage estrogen deficiency symptoms, and to promote prevention of cardiovascular disease and osteoporosis.