Breast Cancer2023-01-04T16:48:43+00:00

Breast Cancer

If you have concerns around using HRT and breast cancer risk or have had breast cancer yourself and would like some information about treatment options then one of our experienced clinicians would be happy to help.

The background population risk of developing breast cancer in your lifetime is 1 in 8 and this will not change much whether you take HRT or not.

There are aspects of your medical history and lifestyle that can increase your background risk of developing breast cancer, usually by only a very small degree. Some of these factors are things we can influence ourselves (weight, alcohol) and others are things we cannot change (family history of cancer, genetics).

Even if you have these risk factors, the chance of developing breast cancer is still small and most women who have some of the above risks will not develop breast cancer in their life.

The increased risk of developing breast cancer associated with taking HRT is understandably a very common concern that women mention when they come to our clinic to discuss HRT.

Breast Cancer: How we help

At Chelvey Menopause we can offer a lifestyle consultation where we can support you to make changes towards healthier living that will benefit you for years to come. Whether its help with weight loss, exercise advice, sleep or to explore psychosexual problems, one of our clinicians will be able to help you. We use CBT and life coaching techniques to help you to explore why these changes have been difficult to make or maintain in the past, and to help come up with achievable goals for the future. In addition we can offer a general health screening blood tests.

Does HRT increase my risk of developing breast cancer?

It depends on the type of HRT that you are taking.

Women without a womb (who have had a hysterectomy) may not need combined HRT and may be able to take oestrogen on its own.

**This does depend on the reason for the hysterectomy- women who have had severe endometriosis are likely to need two hormones for a time, even though they have no womb.

Oestrogen alone is not thought to incur any additional risk of breast cancer over a 5 year period.

The progestogen element of combined HRT has been shown in studies to increase the risk of breast cancer to a very small degree.  This risk depends on the type of progesterone used- the risk is greater with synthetic progestogens and less with body identical preparations.

The risk of developing breast cancer if you drink a glass of wine a night or are overweight is higher than the risk of breast cancer from taking HRT.

Smoking also increases your risk and regular exercise reduces the risk of developing breast cancer.

It is important to remember that if a woman develops breast cancer it is still very unlikely to be because they took HRT and for women with a low background risk of developing breast cancer (most of the population) the benefits of taking HRT for up to 5 years are likely to outweigh the risks.

Can I take HRT if I have had breast cancer myself?2022-11-28T21:59:26+00:00

The discussion around taking HRT after you have had breast cancer yourself is different from discussing additional risk of developing breast cancer from taking HRT if you have never had breast cancer.

Many of the current treatments used to treat breast cancer block oestrogen and cause a woman to experience menopausal symptoms. Women are often advised to stay on these medications for many years.

Unfortunately we do not have many studies looking at the risk of breast cancer recurrence when taking HRT and the studies we do have, have been criticised. However the studies we do have did show a small increased risk of recurrence of breast cancer in women taking HRT after breast cancer and current guidance is that HRT is contraindicated in women with a past history of breast cancer.

It is important to remember that a lack of solid evidence does not mean a lack of harm and the decision to take HRT following treatment for breast cancer needs to involve the cancer and breast teams and a menopause specialist. There may be changes that can be made to a woman’s current breast cancer treatment that on their own can improve menopausal symptoms.

Alternative therapies, both pharmacological (medication) and non-pharmacological can be very effective at managing menopausal symptoms and are usually recommended first line.

Vaginal irritation and dryness is a common symptom which can be quite disabling and may not respond to moisturisers and lubricants. In these circumstances a low dose of vaginal oestrogen can be extremely effective and is thought to be safe as barely any of the oestrogen is absorbed around the body.

An important message here is that every case needs to be managed individually as the type, stage and grade of breast cancer changes the risk of a recurrence along with the fact that the severity of a woman’s symptoms and response to other non-hormonal treatments varies. Shared decision making is vital and it is important that every women feels listened to and has the opportunity to fully explore treatment options and discuss the pros and cons with a specialist thereby feeling fully informed and comfortable with any decision that is made around treatment.

Occasionally a trial of HRT after breast cancer is the right decision for that individual due to the severity of symptoms and the impact of these symptoms on quality of life. This decision is generally made in a multi-disciplinary team setting after non hormonal options have been explored and the risks of HRT have been carefully outlined and discussed.

If I need to take HRT at a younger age does that mean my risk increases over time more than someone who starts HRT at the natural age of the menopause?2022-11-28T21:59:06+00:00

No- if you have premature ovarian insufficiency or early menopause we are simply replacing hormones that you have lost too early. We only start counting ‘years on HRT’ from the age of the natural menopause, around age 51. The ‘extra’ years on HRT if you have had to start it at a younger age are not thought to incur a cumulative risk of breast cancer.

What if I have a Family history of breast cancer?2022-11-28T21:58:38+00:00

Many women will have a relative who has had breast cancer because it is a relatively common cancer.

It depends on the strength of the family history of certain cancers. For the majority of women with a family history of breast cancer this will not change their background risk of developing breast cancer by much and taking HRT is unlikely to contribute to that risk much either.

In these women (the majority) the benefits of taking HRT are likely to outweigh the risks.

Women with multiple family members or close family members who had breast cancer at a young age may require advice from the genetics team before they take

Does using vaginal oestrogen increase my risk of breast cancer?2022-11-28T21:58:15+00:00

No – vaginal oestrogen in thought to be very safe even for long term use as only a very small amount is absorbed around the body.


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