The thoughts of physicians regarding the need to start hormone replacement therapy in breast cancer survivors.

OBJECTIVES: To investigate how physicians felt about HRT use in breast cancer survivors a half year after the WHI trial. METHODS: In December 2002, a questionnaire was conducted in Flanders (Belgium). The survey contained a presentation of a 35-year-old breast cancer survivor who presented with climacteric symptoms after treatment with tamoxifen. RESULTS: With a response rate of 33.65%, a majority of the physicians did not prescribe classical oral HRT (5.40%) in this patient. Physicians prefer to prescribe tibolone (30.68%) or other alternative treatment (50.00%). The main reason was the fear for increased recurrence of breast cancer. Furthermore the WHI oestrogen plus progestin trial and its attention in the media, a half year prior to the survey, influenced one-third of the physician's prescribing attitude. CONCLUSIONS: Two-thirds of the physicians did not change prescribing attitude after the WHI oestrogen plus progestin trial. HRT is a well proven effective treatment in breast cancer survivors with severe climacteric complaints, but a majority of physicians is not convinced of its safety in breast cancer survivors. Therefore, a majority of physicians do not find the need to prescribe HRT in breast cancer survivors.