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HRT and Breast Cancer Risk

HRT and Breast Cancer Risk

The ovaries produce two important sex hormones in a woman: oestrogen and progesterone. The levels of these hormones decline dramatically after the menopause. The normal menopause begins around the age of 50 years in most women.

The menopause is characterised by the ceasing of menstrual periods, hot flushes, and vaginal dryness and discomfort. These symptoms are fairly mild and tolerable in most women, but in others they can be very severe and unpleasant. Hormone replacement therapy (HRT), which contains the female sex hormones oestrogen and progesterone, is sometimes considered to alleviate the symptoms of the menopause and reduce the risk of osteoporosis.

oestrogen (used in HRT) seems to promote breast cancer growth. However, the risk of breast cancer is increased by 30% in women who have taken HRT for more than 5 years.

Women taking HRT should practise self-examination of the breasts and participate in breast cancer screening programmes (one mammogram every two years). It is also worth pointing out that breast cancers that develop in women taking HRT are usually early cancers and have a good prognosis.

If you have had breast cancer, it is worth asking your breast specialist about the type of cancer you had. Some types of breast cancer are sensitive to oestrogen and the hormone stimulates tumour growth, while other types of breast cancer are not affected by oestrogen. If your cancer was of the non-oestrogen-sensitive type, HRT is less likely to increase the risk of the breast cancer returning.

It is the author's opinion that women with breast cancer should avoid using HRT for at least two years after diagnosis. The development of new drugs to reduce the risk of bone loss or osteoporosis, such as bisphosphonates and raloxifene, is likely to reduce the need to use HRT among all women.

A recent study from the USA (the Women's Health Initiative Study) has shown that taking HRT increases the risk of heart disease and breast cancer but decreases the risk of brittle bone disease and large bowel cancer. It is the author's opinion that the disadvantages of HRT outweigh its benefits and should be used only as a last resort.