[What's new in hormone replacement therapy of postmenopausal women? II. Risks of hormone replacement therapy (HRT)].

A 50 year old woman has a 10% lifetime risk of developing a breast cancer. Depending on the duration of the treatment, HRT can increase this risk by 30 to 45%. The risk of endometrial cancer, which affects 2.3% of women, is increased even if sequential progestogens are given together with estrogens. The risk of venous thrombosis is increased 3 times. The occurrence of ictus is not modified by HRT. On the other hand estrogens may prevent the abdominal deposit of fat. The cancer risks associated with HRT must be balanced against their protective effects on cardio-vascular (C-V)diseases. In untreated women, mortality due to C-V disease is 39% whereas mortality due to breast cancer is 3% and only 0.3% for endometrial cancer. This article discusses also the possibility of HRT and of non hormonal treatments in patients with previous breast cancer.