Does HRT Put Women at Risk For Breast Cancer?

Understanding The Latest Research About Hormone Replacement Therapy

For years there have been suspicions and studies linking Hormone Replacement Therapy (HRT) to breast cancer, but new research is now definitively linking HRT to an increase in breast cancer death rates.

It wasn’t long ago that HRT was touted as a cure for menopause symptoms, that would also help your heart, your bones, and even prevent cancer.  From the East Hampton Star – Menopause Matters…

In his 1966 best seller, “Feminine Forever,” Robert Wilson touted the virtue of using hormone replacement therapy and derisively referred to menopausal women as “flabby” and “shrunken.” It was recently revealed by the journal PLoS Medicine and The New York Times that virtually all popular writing supporting hormone replacement at that time was being secretly funded by Wyeth, the manufacturer of these same hormone replacement drugs.

As I discussed in my Jan. 21, 2010, column in The Star, “No Fountain of Youth,” hormone replacement therapy, also known as H.R.T., will quell hot flashes and preserve bone, but it does not prevent heart disease or cancer.

Yes, there really was a time (and not too long ago) that women were told HRT could prevent both heart disease and cancer.  We are now learning that that couldn’t be further from the truth.  From CNN – HRT Increases Breast Cancer Death Risk

This latest research looks at 11 years of follow-up on the health of these women and the authors found that those who had used the therapy were not only more likely to develop but to die from breast cancer.

For decades women have been prescribed HRT – medications containing female hormones to replace the ones the body no longer produces after menopause. These drugs can be very effective at alleviating the hot flashes, night sweats and other discomforts of menopause. They have also been shown to help with bone health and may decrease the risk of colon cancer. But HRT, long heralded as being protective for heart health, has not lived up to its billing and women are now warned about the possible increase risk for heart attack and stroke. Last year a study found that combined HRT also increased a woman’s risk of dying from lung cancer.

The new research, based on data from 16,608 women, found that compared with patients on the placebo, those who took estrogen plus progestin (in a formulation known commercially as Prempro):

  • had a 25 percent higher risk of invasive breast cancers
  • were 78 percent more likely, if diagnosed with breast cancer, to have more advanced cancers, which had spread to the lymph nodes
  • faced about double the risk of dying of breast cancer, and for those with breast cancer, a higher risk of dying of any cause.

From the American Cancer Society – Advanced Breast Cancers, Higher Death Rate Seen with HRT

“It’s a very strong paper. It clearly takes advantage of a well-conducted clinical trial,” says Susan Gapstur, PhD, vice president of the American Cancer Society’s Epidemiology Research Program. “These findings are adding to the growing evidence and concern about long-term effects of estrogen plus progestin.”

. . .

He also noted another report from the Women’s Health Initiative, published in 2009 in The Lancet, indicating that deaths from lung cancer were 71 percent higher among women on combination hormone therapy than among those on placebo. Considering the lung cancer findings, too, “You’re talking about thousands of women being at risk for these diseases when millions of prescriptions are being taken.”

Here is a great (8 minute) video with one of the authors of this latest study discussing this research…

When I was looking for more information to include in this post, I came across a “real life” story that brings the scientific jargon and statistics to the level of you and me.  This is a sad, but in the end inspirational, story of the Carol Saline (author of the book Sisters), who was effected by years of hormone replacement therapy.  This is a small excerpt from the article – Becoming the Story…

Somehow, through all the years of my sister’s ordeal, I’d held on to a wholly irrational conviction that I would never get breast cancer. Was I stupid, naïve or just fooling myself? While neither Patsy nor I carried the BRCA genetic mutation (the marker for inherited breast cancer) and none of the women in our family had had the disease, I’d chosen to play the odds and stayed on hormone replacement therapy for more than 20 years. Once, I’d tried to stop, but the hot flashes and the sleepless nights were intolerable. So I resumed, fully aware that HRT hormones increase the risk of breast cancer. In retrospect, that was probably a bad throw of the dice.

Do the benefits of hormone replacement therapy outweigh the risks? It certainly doesn’t seem so. I think the important thing to remember about HRT is that often with trial and error, other much less risky options can be found to treat the hot flashes and symptoms associated with menopause.

What do you think about this latest research on HRT? Have you used hormone replacement medications? Are there non-hormonal treatments that you have found helpful to treat these symptoms? Tell us your story.

*cross-posted at BlogHer Health & Wellness

1 comment for “Does HRT Put Women at Risk For Breast Cancer?

  1. Cheryl Cummings PA-C
    November 14, 2010 at 7:25 pm

    As a menopausal women and health care provider, I am so disappointed with the latest evidence. Like many of my patients, I too have tried numerous non hormonal therapies. Unfortunately all failed. My symptoms have been dramatic and life altering x 4 years. I am angry that I do not have safe and effective forms of treatment to take, or to offer. The life expectancy of US women is now in the 90’s. Are we to suffer for 45-50 years? I have patients in their 70’s who are still on HRT, because they are unable to tolerate their symptoms without it. So, I like many women are taking HRT, and praying that I am not one of the unlucky who will develop breast cancer. With the resources available to us, we can surely do better, to keep all women safe and well.

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