DOUBT CAST ON ESTROGEN, CANCER LINK

Less than a month after researchers reported that menopausal women taking estrogen may face an increased risk of breast cancer, a new study disputes the link.

The debate isn't likely to end soon. Lead authors of both studies say more research is needed, and both stand by their findings."I know there's a lot of confusion," said University of Washington epidemiologist Janet Stanford, lead author of the new research published in Wednesday's Journal of the American Medical Association.

Stanford's study, which refutes a highly publicized report last month, found that menopausal women who take estrogen alone or with progestin face no increased risk of breast cancer.

Stanford said women should discuss their medical histories with their doctors before making a decision about hormone replacement therapy. "It has to be an individual decision," she said.

Hormone replacement therapy, using estrogen alone or with progestin, is prescribed to ease hot flashes and other menopause symp-toms, as well as to reduce risk of heart disease and brittle bones.

In menopausal women, hormone supplements can cut in half the risk of heart disease, which is the leading killer of women as well as men. Hormone supplements have a similar effect on fractures.

Doctors have long suspected that estrogen, a female sex hormone, may play a role in the development of breast cancer. Women with longtime exposure to increased estrogen levels - those who begin menstruating early or go through menopause late - face a higher breast cancer risk.

But doctors have debated for decades whether there is a similar link involving hormones given to women when their natural estrogen production slows down.

The results of the new study are based on medical histories of 1,029 Seattle-area women ages 50 to 64. About half had been diagnosed with breast cancer.

"We found no overall association between breast cancer risk and the use of either estrogen alone or estrogen with progestin," the researchers wrote.

Use of the combined therapy for eight years or more "was associated with, if anything, a reduction in the risk of breast cancer," and estrogen alone used for 20 years or more showed no increased risk, they said.

Stanford said combined therapy has been popular in the United States only for about a decade, and more research is needed to determine whether longer-term use poses any breast cancer risk.