The articles reviewed agreed that long term use of estrogen-progestin increased the incidence of breast cancer. There are some differences concerning the initiation of ET. One component of the WHI study revealed for women taking unopposed estrogen, there might be a decrease in incidence of breast cancer (Beckmann, 2014). The benefit-risk ratio of ET is favorable for women who initiate ET close to menopause (NAMS, 2012). In addition, the data supports the use of initial ET to reduce the risk of menopausal maladies like: osteoporosis, vasomotor symptoms, vaginal dryness, and overactive bladder (NAMS, 2012). A decreased risk was found among those who never used EPT compared to current users (Eccles, 2013). It is imperative that individualization of therapy occurs in each client. After a comprehensive history has been considered, the APRN and client may review options. Other than long-term therapy and estrogen-progestin combinations, ET can be beneficial to many experiencing unwanted menopausal symptoms and may prevent related disorders. Nevertheless, APRNs should put the risk and benefits on the table for discussion with their clients and offer valuable education on ET, EPT, as well as any phytoestrogen alternatives. Many providers are not educating patients, using cultural considerations, or proactively treating menopausal symptoms when the treatment need arises.
Practitioners have the knowledge and the desire to teach their clients. Their clients wish to learn. The obstacle in providing the information regarding the link between use of hormones and risk of breast cancer is caused by providers who are not giving their clients evidence to make meaningful choices. Also to be considered is ...
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Successful prevention and treatment of breast cancer. Breast Cancer Research, 15, 1-37.
Gordis, L. (2009). Epidemiology (4th Ed), Philadelphia, PA: Saunders Elsevier.
McEwen, M., & Wills, E. M. (2011). Grand Nursing Theories Based on Interactive
Process. (3rd Ed), Theoretical Basis for Nursing (pp.170-174). Philadelphia, PA: Wolters
Kluwer Health/Lippincott Williams & Wilkins.
North American Menopause Society (2012). The 2012 Hormone Therapy Position Statement of
The North American Menopause Society. Menopause: The Journal of the North American
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Norman, S., Weber, A., Localio, A., Marchbanks, P., Ursin, G., Strom, B.,... Nadel, M. (2010).
Hormone therapy and fatal breast cancer. Pharmacoepidemiology and Drug Safety, 19,
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