Estrogen HRT: No Breast Cancer Risk
No Added Breast Cancer Risk With Estrogen-Only Hormone Replacement Therapy After Hysterectomy
WebMD News Archive
"Women have been on a roller coaster ride. That ride is over,"
Taylor says. "For women with hysterectomy, the evidence is clear: Estrogen
is safe for them. There is no breast cancer risk for estrogen alone. This has
been the No. 1 fear keeping women from using estrogen for their menopausal
While the study did not consistently find an overall reduction in breast
cancer, the women on estrogen-only therapy did have significantly fewer cases
of the most common kind of breast cancer -- ductal cancer.
"What was significantly decreased was ductal cancer, the most common
form, a real reduction by almost 30% in the most common kind of breast
cancer," Taylor says.
What about women who have not had a hysterectomy?
"As we see more detailed results from the WHI, we see there are some
reassuring findings for women without hysterectomy," Taylor says. "In
terms of heart disease, in younger women there is no increased risk. Ongoing
studies with newly menopausal women are suggesting a benefit even with combined
estrogen/progestin treatment. There was increased risk of breast cancer, but
this number was very small. ... On balance, the risks of estrogen plus progestin
are very low."
That's a controversial opinion. Boston University epidemiologist Lynn
Rosenberg, ScD, recently analyzed data from a study of more than 23,000 black
women. Reporting in the April 10 issue of the Archives of Internal Medicine,
she finds that women who used hormone therapy -- even estrogen alone -- had a
higher risk of breast cancer than women who never used hormone therapy.
"In my view, the weight of evidence would make me very suspicious of
estrogen alone," Rosenberg tells WebMD. "It seems absolutely certain
that estrogen plus progestin increases the risk of breast cancer, particularly
if you take if for a long time."
Doctors currently prescribe hormone therapy for women who need help with the
symptoms of menopause. Taylor says every woman with these symptoms is a
candidate for this treatment, unless they have a high risk of breast cancer or
a clotting disorder.
"The paradigm of treating menopause symptoms with the lowest effective
dose of hormone therapy, for the shortest period necessary, is very
sensible," Taylor says.