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Hormone replacement therapy (HRT) is a treatment program in which a woman
takes estrogen and progestin (a synthetic form of progesterone) to relieve
menopause symptoms. HRT also reduces a woman’s risk for
osteoporosis and other conditions that become more common after menopause.
While HRT 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 HRT is stopped, and the risk no longer increases
about five years after stopping HRT.
Increased risk with prolonged use
The
length of time a woman takes HRT also affects a woman’s risk. Taking HRT for
five or more years increases the risk more than taking HRT
for two or three years.
Do the benefits outweigh the risk?
The
known link between HRT and increased breast cancer risk has discouraged many
women and their doctors from choosing or recommending hormone replacement
therapy (HRT). Most breast specialists do not recommend HRT for breast cancer
survivors, while others may recommend HRT based on its potential benefits.
The type of hormone replacement 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 HRT. The
decision to use HRT after menopause should be made by a woman and her health
care provider after weighing all of the potential risks and benefits.
New options for HRT
Selective estrogen
receptors (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 70 percent. Although the Food and Drug Administration (FDA)
has approved the drug for osteoporosis prevention,
it is not approved for use in connection with breast cancer prevention and is
presently used only in clinical trials.
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