The WHI (Women's Health Initiative) trial that reported increased breast cancer risk with HRT used which specific regimen?
- A Oral conjugated equine oestrogen (CEE) plus medroxyprogesterone acetate (MPA) ✓
- B Transdermal oestradiol plus micronised progesterone
- C Tibolone alone
- D Oral oestradiol valerate plus dydrogesterone
Correct answer: A. Oral conjugated equine oestrogen (CEE) plus medroxyprogesterone acetate (MPA)
Explanation
The WHI trial used oral conjugated equine oestrogen (0.625 mg/day) combined with medroxyprogesterone acetate (2.5 mg/day) in women with intact uteri, and found increased risks of breast cancer, coronary events, stroke, and VTE. These risks may not extrapolate to transdermal oestradiol with micronised progesterone, which has a more favourable safety profile. This distinction is clinically and examination-relevant.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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