SUMMARY – Postmenopausal Hormone Therapy and Breast Cancer

• The WHI (Women’s Health Initiative Study) agrees with some case-control and cohort studies indicating that long-term current use of combined estrogen and progestin has a slightly increased risk of breast cancer.  <<Here Dr. Speroff admits that long-term hormone replacement therapy may increase the risk of breast cancer by 24%.  However in considering this 24%, you should realize that obesity increases the risk of breast cancer by 100%, and heavy alcohol intake also increases the risk or breast cancer by about 100%.  And let's not forget that talking on your cellphone while you drive your car, increases your risk of having a auto-accident by 400%.  And smoking cigarettes increases your risk of lung cancer by 2,000%.>>  It is still not clear whether this finding is due to an effect of hormonal therapy on pre-existing tumors.  <<Here he is stating that despite all the world's research, there is still no strong evidence that hormones cause breast cancer.  They may just speed up the emergence and detection of small breast cancer tumors that were present, totally unrelated to the hormone therapy.>>
• The epidemiologic data indicate that a positive family history of breast cancer should not be a contraindication to the use of postmenopausal hormone therapy. <<Dr. Speroff finds no evidence that a women with close relatives with breast cancer (mother, sister) has any increased danger from taking hormones.>>
• Women who develop breast cancer while using postmenopausal hormone therapy have a reduced risk of dying from breast cancer.  This is probably because of two factors:  (1). Increased surveillance and early detection: and (2). An effect on pre-existing tumors so that tumors appear at a less virulent and aggressive stage.  <<Here he cited studies showing that if you get breast cancer while you are taking hormones, your outlook is improved.  Specifically in women who get breast cancer while taking hormones: (1) the breast cancer tumors are found at a younger age, (2) they are less agressive, (3) they are smaller, (4) they have a lower chance of spread, and (5) there's a 40-60% less chance of dieing from the breast cancer.>>