Breast Cancer and HRT
There are reports in the media about the risk of Breast Cancer from HRT. It is also said that long-term use of HRT is not recommended. This study was reported in the International Journal of Cancer, and was partly funded by the Cancer Council of NSW. All these reports have to be examined thoroughly and understood. The conclusion we can come to fully supports what I have been saying (and others like me) for some time – Standard, synthetic HRT may increase the breast cancer risk. The women in this study were on the usual, synthetic HRT containing Progestagens, not the natural Progesterone I use. Many of them were on the oral (pill form), which we know increases the risk of breast cancer. Those of you who have been following this blog understand that hormones should always be given transdermally, either by creams or troches. The other difference is that these women were on the “one size fits all” HRT. It is essential that the dose is tailored to the individual person. Finally, if used correctly, using Bioidentical hormones, the research shows that there is significant long-term benefits. ( see my web-site under Menopause Recommendations)
Finally, I have been using BHRT for the last 25 years in over 4000 women. Doing a search of my database reveals about 5% (1 in 20) of my patients have developed breast cancer while on the BHRT. The national average is about 10-12 % (1 in 8) of all women will develop breast cancer. These figures will be reassuring to those of my patients on BHRT.
Here is one of many studies confirming the above. More available on my web-site under Safety Of BHRT.
Could transdermal estradiol + progesterone be a safer postmenopausal HRT? A review.
- 1Department of Gynecology and Obstetrics, Université Libre de Bruxelles, Bruxelles, Belgium. email@example.com
Hormone replacement therapy (HRT) in young postmenopausal women is a safe and effective tool to counteract climacteric symptoms and to prevent long-term degenerative diseases, such as osteoporotic fractures, cardiovascular disease, diabetes mellitus and possibly cognitive impairment. The different types of HRT offer to many extent comparable efficacies on symptoms control; however, the expert selection of specific compounds, doses or routes of administration can provide significant clinical advantages. This paper reviews the role of the non-oral route of administration of sex steroids in the clinical management of postmenopausal women. Non-orally administered estrogens, minimizing the hepatic induction of clotting factors and others proteins associated with the first-pass effect, are associated with potential advantages on the cardiovascular system. In particular, the risk of developing deep vein thrombosis or pulmonary thromboembolism is negligible in comparison to that associated with oral estrogens. In addition, recent indications suggest potential advantages for blood pressure control with non-oral estrogens. To the same extent, a growing literature suggests that the progestins used in association with estrogens may not be equivalent. Recent evidence indeed shows that natural progesterone displays a favorable action on the vessels and on the brain, while this might not be true for some synthetic progestins.
Compelling indications also exist that differences might also be present for the risk of developing breast cancer, with recent trials indicating that the association of natural progesterone with estrogens confers less or even no risk of breast cancer as opposed to the use of other synthetic progestins.
In conclusion, while all types of hormone replacement therapies are safe and effective and confer significant benefits in the long-term when initiated in young postmenopausal women, in specific clinical settings the choice of the transdermal route of administration of estrogens and the use of natural progesterone might offer significant benefits and added safety.
- [PubMed – indexed for MEDLINE]