A Decline in Breast-Cancer Incidence

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Abstract
In their Special Report on the decrease in the incidence of breast cancer in the United States in 2003, Ravdin et al. (April 19 issue)1 state that a 2002 report by the Women's Health Initiative (WHI)2 noted a significant increase in the risk of breast cancer associated with the use of estrogen–progestin combination therapy by postmenopausal women. However, the increased risk of breast cancer in the WHI study did not reach statistical significance. The increased risk of breast cancer in the follow-up report3 barely achieved statistical significance, and no increased risk was found among WHI study subjects taking estrogen alone, as compared with those who did not receive hormone-replacement therapy.4