Hormone Replacement Therapy & Breast Cancer

Hormone Replacement Therapy is a medicine which is used to help menopausal women cope with their more unpleasant symptoms. Menopause usually starts between the ages of 42 and 58 years. However it can in some cases start much earlier. It is a known fact that HRT can increase the risk of breast cancer, although a piece of research known as the `Million Women Study’ quantified the risk for oestrogen only HRT. It has also shown the use of combined HRT is associated with a higher than expected increase in the risks that were studied.

A study funded by Cancer Research UK, the NHS Breast Screening Programme and the Medical Research Council on 1,084,110 women ages 50 and 64 years in the UK. Half of the women had used HRT and amongst them were 9,364 cases of invasive breast cancer, 637 resulting in death.
Scientist analysed the data and discovered post-menopausal women who had taken the combination HRT were twice as likely as the non-users to develop breast cancer. Those women taking tibolone had an increased risk of developing the disease by 45%. Those women who took oestrogen only HRT had a 30% greater risk of developing breast cancer than the non-users of HRT.

It is predicted that among 1000 postmenopausal women who don’t use HRT, there will be approximately 32 cases of breast cancer in women who are between the ages of 50 and 65.
There will be 5 extra cases of breast cancer for every 1000 postmenopausal women who take oestrogen only HRT for 10 years.

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For every 1000 postmenopausal women who take the combined oestrogen-progesterone HRT for 10 years, the will be approximately 19 extra cases of breast cancer.

The increased risk begins to become apparent within the first to second years of starting either form of HRT and it increased with the length of time it is taken. When the HRT is stopped the risk begins to decline and after five years, the likelihood of developing breast cancer is the same as for those women who have never taken the drug.

Combined oestrogen and progestogen HRT is normally prescribed for those women who still have their uterus to avoid the increased risk of cancer of the uterus caused by oestrogen only therapy.
Any women who feel concerned about these medications or wish to change or stop their form of HRT should make an appointment with their doctor. As with all medications, the doctor’s decision to use HRT needs to be made on a women’s individual basis, taking into account her symptoms, family history, personal health, the risks and benefits of HRT and any alternative options that are available for the treatment of non desired menopausal symptoms.

Women should always be encouraged to attend regular breast screening and check their own breasts for any abnormalities on regular intervals.