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Estrogen-Only HRT Safe for 15 Years

After Hysterectomy, Breast Cancer Risk Rises Only After 15 Years of HRT

How Much Breast Cancer Risk? continued...

The risk tended to concentrate in thinner women -- those with a body mass index under 25. That finding was what researchers call a "trend." It could have been chance, but there's good reason to think it is real.

"Heavier women are well known to have higher levels of estrogen, because fat tissue converts other things in your body into estrogens," Chen says. "It's the same reason why birth control pills, which contain much more estrogen than HRT, aren't linked to breast cancer. That is because before menopause, a woman has a lot of estrogen, and adding a lot of estrogen doesn't affect her hormone balance as much as adding a little estrogen affects a postmenopausal woman who doesn't have as much in her body."

Making Treatment Decisions

The findings are good news to James Pickar, MD, assistant vice president of clinical research and development for Wyeth."For the majority of women taking estrogen in the 10-year window after hysterectomy, this finding of no increased risk in that time frame should be reassuring," Pickar tells WebMD. "We have not changed our recommendations or our labeling. Women should discuss with their doctors using the lowest dose that works for them for a time consistent with their treatment goals."

Taylor says it's good news for women, too.

"With estrogen alone, the biggest fear women have isn't there," Taylor tells WebMD. "For a woman with a hysterectomy, the decision about whether to take estrogen is an easy decision today. The heart protection is there. The bone protection is there. The breast cancer risk isn't there. For women with no hysterectomy, the decision remains more difficult."

Chen, Taylor, and Pickar agree that a woman taking HRT should see her doctor at least once a year. At each visit, she should discuss whether the benefits of HRT are worth the risks of continuing treatment.

Even though short-term estrogen-only HRT doesn't carry a breast cancer risk, it's not risk free. The treatment does increase a woman's chances of blood clots and stroke.

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