Hormone Therapy and Breast Cancer: Clearing the Confusion and Fear

By: Red Hot Mamas

Published: October 19, 2012

Women know hormone therapy (HT) relieves menopausal symptoms but they are fearful because of conflicting information about its safety. That’s why today fewer than 20% of menopausal take HT! This is compounded by the mass media who often sensationalize the news to grab your attention and make it more compelling. The decision about HT is too important to base on a few sound bytes. Empowering yourself with the facts enables you to actively participate with your physician in making an informed decision about HT.

The number one reason women deny themselves estrogen is fear of breast cancer. If this risk is not put in proper perspective at the outset, it’s difficult for women to evaluate the benefits of estrogen with a clear, rational frame of mind. As an endocrinologist and a pharmacist, I inform my patients that all drugs have risks. The key is to select the drug with the most benefits and the fewest risks. Hearing a sound byte that estrogen increases breast cancer is meaningless unless you know the absolute numbers.

To evaluate the risk of breast cancer from HT, women need to first know that breast cancer can occur in women who NEVER take HT. In published studies of 10,000 women on no HT for five years, 30 developed breast cancer. This is believed to be the natural occurrence of breast cancer. However, the more important question is how much MORE does your risk increase if you take HT? In 10,000 women on HT for five years, 38 will develop breast cancer. This is only an increased risk of EIGHT cases of breast cancer! This represents a risk of 1 in 1000 and World Health Organization defines this as a RARE risk.

What about the other 9,962 women in the study who took HT, DIDN’T get breast cancer and were protected against getting heart disease, strokes, osteoporosis, Alzheimer’s disease and enjoyed a better quality of life? Heart disease is the number one killer of women and last year more women died of heart attacks than men! Heart disease and strokes kill more women each year, 400,000, than the next 16 causes of death including diabetes, all forms of cancer, AIDS and accidents! In women genetically at risk, HT reduces the risk of Alzheimer’s Disease by 50%. A study has estimated the lifetime risk of any fracture to be 53% among 50-year-old women not taking HT. Compare this to the lifetime risks of endometrial cancer 2.6%, breast cancer 10%, heart disease 46% and stroke 20%.

Now you can see there are far more risks from NOT taking estrogen! Estrogen is most effective at prevention when used in newly menopausal women or those within 10 years of stopping HT. Don’t miss out on this window of opportunity by waiting too long to make your decision. If millions of Baby Boomer women enter advanced menopause on no HT, imagine the burden to society. We all have a responsibility not only to ourselves but to our families to be proactive and accountable so we can enjoy the most vitality and productivity in our later years.

References

  1. Roussoue, JE, Anderson GI, Prentice RL, et al, “Risks and Benefits of Estrogen plus progestin in healthy postmenopausal women: principle results from the Women’s Health Initiative, randomized-controlled trial,” Journal of the American Medical Association, vol 288, no.3, (2002): pp 321-333
  2. CDC (2006) National Vital Statistics Reports vol 57(14): pp1-135, April 17, 2009
  3. Paganini-Hill A, Henderson VS, “Estrogen Deficiency and Risk of Alzheimer Disease in Women, American Journal of Epidemiology, vol 140, no 3P(1994): pp 256-261
  4. Tschanz JI, Trieber K, Norton PD, et al, (2005), “A Population Study of Alzheimer’s Disease: Findings from the Cache County Study of Memory, Health and Aging,” Case Management Journals vol 6: (2):pp107-114
  5. Dennison E, Mohamed MA, Cooper C., “Epidemiology of osteoporosis,” (2006 Nov) Rheumatologic Diseases Clinics North America vol32(4):617-29

About the Author: Marina Johnson, MD is the Medical Director of The Institute of Endocrinology and Preventive Medicine in Irving, TX. Prior to medical school, she was a pharmacist and assistant editor for a drug reference book, AHFS-Drug Information. Her medical practice focuses on women’s hormone health and cardiovascular prevention.

More information:
It Took a Decade to Smarten Up on Hormone Therapy A New Perspective on Hormone Therapy
Estrogen Alone for Menopause Symptoms
A Brief Primer on Hormone Therapy
New Outcome Data From WHI: Reflection and Commentary

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