Research has shown that (Hormone Replacement Therapy) HRT, often prescribed to curb menopausal symptoms such as hot flushes, night sweats, fatigue, sleep, and weight gain issues, can increase the risk of breast cancer. Of the two types of HRT available, each one seems to have a different effect on breast cancer risk.
HRTs and Breast Cancer
According to Cancer Research UK:
“Breast cancer: combined HRT slightly increases the risk of breast cancer. This increased risk gets bigger the longer HRT is used. When HRT is stopped, the increased risk goes down over time. This takes longer, the longer that HRT is used. Combined HRT affects breast cancer risk more than estrogen-only HRT.”
In the short term, estrogen-only HRT appears less risky. This is as per the BMJ study of 98 611 women aged 50-79 with a primary diagnosis of breast cancer between 1998 and 2018[2]. Further indications included:
- Exposure to most hormone replacement therapy drugs is associated with an increased risk of breast cancer, with lower increased risk associations between longer-term HRT use and breast cancer.
- There is a noticeable decline in risks once HRT is stopped.
- Risk increases were mostly associated with combination treatments (estrogen-progestogen) treatments, with small increases associated with estrogen-only treatments.
- Duration increased risk with no increased risk for less than one year of treatment but increased risk for longer exposures to medroxyprogesterone, norethisterone, and levonorgestrel.
- The risk is higher for older women.
Breast cancer diagnosis
It must be emphasized that being diagnosed with breast cancer doesn’t necessarily mean that you will die of it. If you are on HRT, and for at least 10 years after that, you should have regular annual screening mammograms, as virtually all screen-detected breast cancers will be cured with appropriate multidisciplinary treatment.
Remember, too, that hormone replacement therapy also has benefits such as the prevention of osteoporosis and severe hot flashes, to name but two.
Taking HRT
Research suggests that since breast cancer risk is dependent on the duration of time that you use HRT for, it is advisable to rather request if you can take a lower-dose formula. Further, speak to your doctor about the possibility of taking it for the shortest time possible.
If you’ve been diagnosed with breast cancer, or have tested positive for a genetic abnormality that causes breast cancer, such as disease-causing BRCA1 or 2 mutations[3], the use of HRT should not take place.
Am I at risk?
If you have never been genetically tested for breast cancer causing genetic mutations, you are only likely to have an abnormal breast cancer gene if the following applies to you:
- You have first-line blood relatives diagnosed before age 50.
- There is both breast and ovarian cancer in your family, particularly in a single individual.
- Women in your family have had cancer in both breasts.
- A man in your family has had breast cancer.
- You are of Ashkenazi Jewish (Eastern European) heritage.
However, it must be noted that genetic mutations only cause about one in ten of breast cancers. Therefore, just because you don’t have the gene mutation does not mean you are immune. In fact, 70 – 80% of women who have breast cancer have had no family history of the disease.
Conclusion
Whether or not you take HRT, there are also lifestyle choices you can make to keep your breast cancer risk as low as it can be. These include maintaining a healthy weight, regular exercise, limiting alcohol consumption and stopping smoking. However, if your quality of life is being impacted upon, it is essential that you speak to your doctor to receive the medical advice and help that you need.
