HRT May Increase Breast Cancer Risk

By Kyle Roderick
ThirdAge Staff

Over thirty-nine million women in the United States are now in menopause, reports the North American Menopause Society, and many of these women will use hormone replacement therapy (HRT) at some point.

HRT's effects on breast cancer risk, however, are poorly understood. Some studies indicate that taking HRT, which consists of estrogen plus progestin, may put women at increased risk for breast cancer, while others show relatively little rise in the odds.

Over the past few decades, HRT has evolved into a popular treatment option for menopausal women. Because estrogen replacement therapy (ERT) alone increases risk of developing endometrial (uterine lining) cancer, most physicians now prescribe HRT, a reduced dose of estrogen, plus progestin which counteracts estrogen's negative effect on the uterus.

Despite potential risks, many women value HRT for the relief it brings to menopausal mood swings, depression, anxiety, hot flashes and sleep disturbances. Equally important, HRT diminishes vaginal discomfort by increasing thickness, elasticity and lubrication of vaginal tissue.

Now for the down side: Studies have found that "breast cancer risk may be increased by up to 40 percent with five years of HRT use," says Malcolm Pike, Ph.D., a professor at the University of Southern California's Keck School of Medicine.

Still, "many women weigh the risks of HRT and decide that the benefits far outweigh the breast cancer risks," said Lisa Masterson, M.D., an ob/gyn in California. (It's also true that many cancer researchers believe that there's a negligible risk associated with taking HRT for 10 years or less.)

Masterson, who has a private practice in Santa Monica, adds, "Women need to remember that HRT has been proven in many women to lower risk of cardiovascular disease, osteoporosis, colon cancer, Alzheimer's disease and glaucoma. These are potentially significant benefits."

What's more, Masterson says one of the studies that Pike refers to "has some holes in it. The researchers used HRT dosages that are significantly higher than what is currently prescribed."

Masterson recommends that any woman considering HRT schedule an appointment with her physician to discuss what HRT use might mean in light of her individual breast cancer risk factors.

"Breast cancer prevention is a crucial women's health issue and to take or not to take HRT is a highly individualized decision," she advises.

- - - - -

Assessment: Is HRT right for you?