Hormone Replacement Therapy and Breast Cancer

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(Also Called 'Hormone Therapy', 'HRT')

Hormone therapy (HT) is a treatment program in which a woman takes estrogen and progestin (a synthetic form of progesterone) to relieve menopause symptoms. HT also reduces a woman’s risk for osteoporosis and other conditions that become more common after menopause.

While HT has many benefits, it has been shown to increase a postmenopausal woman’s risk of developing breast cancer, especially after age 60. Studies show the risk is reduced when HT is stopped, and the risk no longer increases.

Increased risk with prolonged use
The length of time a woman takes HT also affects a woman’s risk. Taking HT for five to 10 or more years increases the risk.

Do the benefits outweigh the risk?
The known link between HT and increased breast cancer risk has discouraged many women and their doctors from choosing or recommending hormone therapy (HT). Most breast specialists do not recommend HT for breast cancer survivors, while others may recommend HT based on its potential benefits, including quality of life concerns.

The type of hormone therapy (estrogen only or combination of estrogen and progestin), as well as the woman’s individual characteristics and symptoms should be considered when weighing the risks and benefits of HT. The decision to use HT after menopause should be made by a woman and her health care provider after weighing all of the potential risks and benefits.

Newer options for HT
Selective estrogen receptor modulators (SERMs) are a newer class of drugs -- similar to estrogen -- that protect against osteoporosis by increasing bone density, while protecting against the development of breast cancer. A recent study showed the SERM raloxifene, marketed as Evista®, reduced the risk of breast cancer in postmenopausal women by 50 to 90 percent. The Food and Drug Administration (FDA) has approved Evista for a very specific breast cancer indication: for the reduction in risk of invasive breast cancer in postmenopausal women at high risk for invasive breast cancer. It is important to understand that Evista did NOT receive approval for treatment of invasive breast cancer, reduction of the risk of recurrent breast cancer, or reduction of the risk of noninvasive breast cancer. Tamoxifen (Nolvadex®), another SERM, is also FDA approved for the reduction of the incidence of breast cancer in women at high risk. It is also approved for the treatment of metastatic breast cancer (cancer that has spread beyond the breast tissue), adjuvant breast cancer, and ductal carcinoma in situ.

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Last Updated: 1/22/2009

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