Breast Cancer and HRT

Breast Cancer and HRT The Problem
Many women have been told that if they have had breast cancer, they cannot go on HRT. Why is this?

The Reason
Hormone Replacement Therapy (HRT) usually contains replacement estrogen. Estrogen is known to help promote breast cancer growth when the cancer is already present. Consequently, HRT containing estrogen is not usually prescribed for women who have had breast cancer, as it is feared that it may trigger a cancer recurrence. High doses of estrogen can stimulate growth of estrogen sensitive cancer and several studies have linked increased breast cancer risk to estrogen replacement therapy. However, new evidence suggests that there may be some cases where HRT is appropriate, even in cases of previous breast cancer.

On the Other Hand&
However, cancer treatment itself induces premature menopause in the vast majority of women. Thus, women are exposed to the risks of menopause related disease for many more years than the average woman. This creates a dilemma. Some breast cancer survivors may be at greater risk of dying from heart disease or osteoporosis than for recurrence of their cancer.

Each year, 233,000 American women die of cardiovascular disease, 65,000 die from complications of hip fractures (commonly as a result of osteoporosis) and 43,000 die of breast cancer. Although breast cancer is the more feared of these three health issues, it is actually a less serious problem than either cardiovascular disease or osteoporosis. When doctors are deciding whether to put a patient on estrogen replacement therapy, they need to carefully weigh the risks that the patient has for each of these health issues.

Doctors are cautiously moving from the old position of "no hormones" for breast cancer survivors. Whether or not the woman's cancer had estrogen receptors, the results of future clinical trials, and the development of selective hormone replacements (pills that give the effects you want without those you do not want) will all effect the decision.

A Note of Caution
One word of caution is in order. Many herbal estrogen supplements contain phytoestrogens, which are estrogens derived from plants. Phytoestrogens are known to be linked to endometrial hyperplasia, which is an overgrowth of cells in the uterus that can increase the risk of cancer. If you want to be on estrogen therapy and you have had breast cancer, you must speak to your doctor to carefully weigh the pros and cons of prescription estrogen.

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