The news media has done a very poor job in informing women about the risks and benefits of hormone replacement therapy (HRT), i.e. the use of estrogen and/or progesterone. They have especially twisted the truth about the relationship of HRT and breast cancer. There has been a huge media blitz on this relationship and the media has scared a lot of women into discontinuing to take their hormones. I would like to clear the air regarding this relationship so that women can make an informed decision regarding taking hormone replacement therapy post menopause.
There have been many research studies over the years that have addressed this issue. Some have shown a slight increased risk, some a slight decreased risk, and some have shown no different risk in developing breast cancer whether one takes HRT or not. Unfortunately, the news media has only grasped the bad news and blown it out of proportion to the good news and scared many women so they no longer receive the many benefits of taking hormone replacement therapy.
The most talked about study was the WHI study (Women’s Health Initiative). Initially, the study showed that women who took combined HRT of estrogen and progesterone had an increased risk of developing breast cancer. They saw 7-8 more cases of breast cancer occurred per year per 10,000 women. The news media had a heyday on this so many women discontinued their HRT. Unfortunately, the news media did not hype up the fact that two years after the study was released, these numbers were shown to not be statistically significant. In other words, the real results should have stated that women had essentially the same risk of developing breast cancer with or without HRT.
In addition, the news media did not tell the public that HRT using estrogen alone actually had a decreased risk of developing breast cancer of 4-5 less cases per year per 10,000 women. This also was not statistically significant but, once again, it can be stated that the risk of developing breast cancer is essentially the same with or without HRT. Thus, women should realize this and continue with their HRT if it is beneficial to them.
There is even more good news about estrogen and breast cancer, but let’s first discuss how breast cancers are formed. We know that breast cancer occurs because of a mutation in a gene of a breast cell. The mutation causes the growth of the cell to occur rapidly and it reproduces itself uncontrollably. The mutation seems to happen spontaneously and the reason for this is still unclear. However, usage of hormones in low dose, as we do with HRT, does not seem to make the mutation happen. Therefore, the cancer would occur with or without the hormones.
Hormones, particularly estrogen, stimulate the growth of breast cells. We know this because during puberty a woman’s breasts grow larger because of the secretion of estrogen from their developing ovaries at that time. The same goes for the growth of breast cancer cells. If estrogen is present in the woman’s body and she develops a breast cancer, it could stimulate it to grow faster.
The good thing about this is that if the breast cancer grows faster, it may be detected earlier. If detected earlier, the cancer may be treated at an earlier stage which usually results in a better outcome. Moreover, many studies suggest that the type of breast cancer seen while women take HRT is usually a less aggressive type of breast cancer. Bottom-line is that the cure rates for these types of breasts cancer are usually very good and better than those where no HRT was used.
Therefore, any way you look at it, taking estrogen therapy may be a better way to go for many women regardless of whether they develop a breast cancer or not. The key is early detection, which usually can be accomplished via regular self breast exams, yearly physical exams, and mammograms when indicated.
Taking estrogen for menopausal problems can be very beneficial to your health, your quality of life and the way you look and feel. They can help decrease the risk of developing many health problems, such as osteoporosis. Discuss these benefits with your doctor and don’t be frightened to take something beneficial to you because of misinformation from poorly informed media hypes.
Robert L. True, MD, FACOG, AACS Colleyville, TX817-399-TRUE Smart Choices for a Better Body: SmartLipo – Smart Breast Aug – Smart Tummy Tuck – Aesthetics – Gynecology – The True Wellness