Supplemental estrogen replacement.

In the current aging society, more than 30 million women have an average postmenopausal life expectancy of 28 years. Coronary heart disease is the leading cause of death in older women, and osteoporosis results in an estimated 1.5 million fractures per year. Various studies have suggested that postmenopausal estrogen-replacement therapy could reduce the morbidity and mortality associated with these conditions. Given the uncertainty about hormone interactions and the molecular genetics of breast cancer, it seems unwise to inject yet another element into the prognostic equation, and currently it is not recommended that estrogen-replacement therapy be used routinely in patients who have been treated successfully for breast cancer. The final decision, of course, rests with the patient and her treating physicians and is subject to medical/legal interpretation.