June 2002

Dear Ms. [ERT participant's first and last name]

We promised to let you know when there was new information about the Hormone Program. There are two studies in this Program‹you are in the study of estrogen alone for women who had a hysterectomy before joining WHI. The enclosed "WHI HRT Update" describes important news about the other study of estrogen plus progestin for women who had not had a hysterectomy. Although you are not in the estrogen plus progestin study, we want you to be aware of the new findings.

The WHI Data and Safety Monitoring Board (DSMB) has recommended that your study of estrogen alone continue, because it remains uncertain whether the benefits outweigh the risks. Currently, there is no increased risk of breast cancer in women taking estrogen alone. The DSMB will continue to review the data every 6 months and we will inform you immediately if they have new recommendations.

• Please continue taking your study pills as you have in the past.
• Continue your regularly scheduled clinic contacts and annual mammograms.
• Continue to participate in any other WHI programs you joined.

I have asked the Clinical Coordinating Center to send you this letter. More information is available in the attached "WHI HRT Update" and on the World Wide Web at: http://www.whi.org. Please share this information with your health care provider. Your WHI clinic staff is also available to answer your questions.

These results are enormously important and will inform millions of women and their doctors worldwide about the risks and benefits of estrogen plus progestin. The findings from this study could not have been predicted when we began in 1993. You are a vital part of this historic study, which is expected to influence medical care for current and future generations. Thank you for our dedication, both past and future, to the WHI Hormone Program.

Sincerely yours,