Does hormone replacement therapy (HRT) increase your risk of breast cancer?

It’s one of the biggest concerns women have when considering hormone therapy for perimenopause and menopause — and the answer is much more nuanced than a simple yes or no.

In this video, I break down what The Menopause Society and the Women’s Health Initiative (WHI) evidence actually tell us about menopausal hormone therapy and breast cancer.

We discuss:

• Why estrogen alone is different from estrogen + progestogen

• What the WHI found about breast cancer incidence and mortality • Why the type and duration of hormone therapy matter

• What we know — and don’t yet know — about micronized progesterone • Why absolute risk and your individual baseline risk matter

• Why hormone therapy should be individualized rather than viewed as simply “safe” or “dangerous”

One particularly important finding: in long-term follow-up of the WHI randomized trials, women with prior hysterectomy who received conjugated equine estrogen alone had significantly lower breast cancer incidence and mortality than those receiving placebo.

In contrast, conjugated equine estrogen plus medroxyprogesterone acetate was associated with higher breast cancer incidence. That does not mean estrogen prevents breast cancer or that hormone therapy is appropriate for everyone. It demonstrates why we cannot treat every form of menopausal hormone therapy as though it carries the same risk.

The goal isn’t to convince every woman to take hormones. It’s to give women accurate information so they can make an informed decision with a knowledgeable healthcare professional.

SOURCES

The Menopause Society. The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause. 2022. Chlebowski RT, Anderson GL, Aragaki AK, et al. Association of

Menopausal Hormone Therapy With Breast Cancer Incidence and Mortality During Long-term Follow-up of the Women’s Health Initiative Randomized Clinical Trials. JAMA. 2020;324(4):369–380. doi:10.1001/jama.2020.9482 Rossouw JE, Anderson GL, Prentice RL, et al. Risks and Benefits of Estrogen Plus Progestin in Healthy

Postmenopausal Women: Principal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA. 2002;288(3):321–333. This content is for educational purposes only and is not a substitute for individualized medical advice.