A major issue surrounding HRT and ERT is the influence of estrogen
on breast cancer. Researchers believe that the longer your lifetime
exposure to naturally occurring estrogen, the greater your risk of
breast cancer. It has not been proven, however, that estrogen
administered at menopause has the same effect. There is disagreement
on the many trials conducted to date because of wide variations in
the populations studied and the doses, timing, and types of estrogen
used. A recent analysis of previous studies suggests that low-dose
estrogen taken on a short-term basis (10 years or less) does not pose
increased risk of breast cancer. Long-term use (more than 10 years)
at a high dose may significantly increase the risk. By how much is
still a matter of heated debate. At the very most, researchers think
long-term use could possibly increase the risk of getting breast
cancer by 30 percent. This means that incidence would rise from 10
women per 10,000 each year to 13 women per 10,000 each year. To reach
any consensus, however, more women need to be monitored for an
extended period of time. The fear of cancer is one of the most common
reasons that women are unwilling to use HRT. Interestingly, actual
death rates for breast cancer have not risen at all. This may be
because estrogen users have more frequent medical visits and obtain
more preventive care including yearly mammograms.
While no one can determine who will eventually develop breast
cancer, there are certain risk factors you should be aware of when
considering HRT. A family history of breast cancer (sister or mother)
is probably the most important risk factor of all. You may also be at
an increased risk if: you menstruated before age 12; delayed
motherhood until later in life; or have a late menopause (after age
50). Also, the older you are, the higher the risk. Most doctors
believe that if you are not in a high-risk category for breast or
endometrial cancer, the benefits of HRT far outweigh the risks.
However, for some women, the side effects of therapy make it
impossible to use. This is a personal decision to be made by each
woman with help from her doctor.
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Reproduced from the National Institute on
Aging, National Institutes of Health.
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