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Family History of Breast Cancer: Should You Take HRT?

Updated: Jul 17, 2024


Understanding Your Risks and Making Informed Decisions


If you have a family history of breast cancer, you may be concerned about whether Hormone Replacement Therapy (HRT) is safe for you. This guide aims to provide clarity on the topic. For personalized advice on your specific risk of inheriting breast cancer, consult your doctor.


What is HRT?


HRT stands for Hormone Replacement Therapy, a treatment used to alleviate symptoms of perimenopause and menopause by replacing the hormones that decline during this time. Symptoms of low hormone levels include hot flushes, night sweats, anxiety, mood swings, brain fog, and vaginal dryness. Over time, low hormone levels can increase the risk of osteoporosis, heart disease, type 2 diabetes, dementia, bowel cancer, and depression.


HRT not only helps improve these symptoms but also aids in preventing these long-term health issues.


Components of HRT


HRT typically involves two main hormones: estrogen and progesterone. Estrogen is the primary hormone that helps alleviate menopausal symptoms. It is often administered through the skin via patches, gels, or sprays.


Progesterone (or a synthetic form called progestogen) is usually recommended for women who still have their womb to keep the uterine lining thin and healthy. This can be taken as a tablet or delivered via a Mirena coil.


Testosterone is occasionally prescribed to help with symptoms such as low libido, fatigue, and poor concentration.


Risks of HRT for All Women


For most women, the benefits of HRT outweigh the risks. The risks associated with HRT depend on the type of therapy, the woman’s age, and her overall health. It’s crucial to have a personalized consultation with your doctor to discuss your specific risks.


While some women worry about breast cancer when considering HRT, most types of HRT do not increase this risk. Research indicates that combined HRT (estrogen and progestogen) may carry a very slight increase in breast cancer risk, particularly with certain types of progestogens. However, taking micronized progesterone (body-identical progesterone) does not show an increased risk.




Could Perimenopausal Estrogen Prevent Breast Cancer? Exploring the Differential Effects of Estrogen-Only Versus Combined Hormone Replacement Therapy

Isaac Manyondaa, Vikram Sinai Talaulikarb, g, Roxanna Pirhadic, John Wardd, Dibyesh Banerjeee, Joseph Onwudef Link to full paper


Even for those using synthetic progestogen, the increased risk is minimal and comparable to risks associated with other lifestyle factors, such as alcohol consumption or being overweight. Importantly, no studies have found that HRT increases the risk of dying from breast cancer.


Women who have had a hysterectomy and take estrogen alone may have a lower risk of breast cancer than those who do not take HRT. Additionally, women under 51 using any type of HRT do not show an increased risk of breast cancer.


Oral estrogen does carry a small risk of blood clots, but this risk is not present with transdermal estrogen (patch, gel, or spray).


HRT and Family History of Breast Cancer


Breast cancer is relatively common, and many women have a family history of the disease. However, only about 10% of breast cancers are due to genetic or familial causes.


If you have a family history of breast cancer, it is important to discuss HRT with your doctor. A woman’s lifetime risk of breast cancer is about 1 in 7, meaning that 1 in 7 women will develop breast cancer, but not necessarily due to HRT. There is no substantial evidence to suggest that having a family history of breast cancer increases your risk from taking HRT compared to women without a family history.


In fact, some studies suggest that women with a family history of breast cancer who take HRT may have a lower future risk of developing the disease compared to those who do not take HRT. This includes women with BRCA gene mutations.


HRT can generally be taken safely by women with a family history of breast cancer, and many health benefits justify its use. Women can continue HRT indefinitely without needing to stop at a certain age.


Final Advice


To lower your risk of breast cancer:


• Maintain a healthy weight

• Exercise regularly

• Avoid smoking

• Limit alcohol intake


Regular self-examinations of your breasts for any unusual changes are also essential.


In conclusion, HRT can be a safe and beneficial option for women with a family history of breast cancer, provided it is managed with the guidance of a healthcare professional.


References


Jean Hailes for Women’s Health. (n.d.). Menopause and Hormone Replacement Therapy (HRT).


Australasian Menopause Society (AMS). (n.d.). Hormone Replacement Therapy (HRT).


NHS. (n.d.). Hormone Replacement Therapy (HRT)


Balance menopause website





Dr Purity Carr

GP & Menopause Doctor

Harvey, WA

Comments

Welcome to Purity Health Women’s Menopause and Wellbeing Centre™

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At Purity Health, we believe in living life to the fullest. Dr Purity Menopause Clinic, in association with Samy Medical Group, is dedicated to providing safe, evidence based information and care in perimenopause, menopause, histamine related conditions, and metabolic health.

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We recognise that there are many myths and misunderstandings surrounding menopause and Hormone Replacement Therapy, HRT. One commonly repeated belief is that oestrogen causes breast cancer. This is an oversimplification and does not reflect the full body of evidence.

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Here is the truth.

At Dr Purity Carr Menopause Clinic, we are committed to providing accurate information and personalised care.

Follow us on #drpuritycarr

Extensive evidence shows that for women within 10 years of menopause or under the age of 60, the benefits of HRT generally outweigh the risks.

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For women who start HRT during perimenopause or within 10 years of menopause, there is often no need to stop purely based on age. Ongoing use should be individualised and guided by clinical review.

Even for women who are further beyond menopause or over 60, starting HRT may still be considered under the guidance of a knowledgeable practitioner, with careful assessment of risks and benefits.

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A Broader Approach to Women’s Health

Dr Purity is a General Practitioner with a special interest in menopause care, taking a holistic, systems based approach to women’s health.

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In addition to menopause, her work now includes:

Hormone health, including perimenopause and menopause
Histamine related conditions, including suspected mast cell activation patterns
Metabolic health, including weight management, insulin resistance, and inflammation
The interaction between hormones, the immune system, and the nervous system

Many women experience symptoms that do not sit neatly within one system. Hormones do not operate in isolation. There is often an overlap between hormonal changes, histamine activity, and metabolic dysfunction. This integrated approach allows for a deeper understanding of symptoms such as fatigue, anxiety, poor sleep, weight gain, brain fog, and chronic inflammation.

 

Dr Purity’s Focus on Care

Dr Purity focuses specifically on menopause, histamine balance, and metabolic health. She works to identify underlying drivers of symptoms and supports women through evidence based, personalised care.

Please note that Dr Purity does not replace your general practitioner. The experienced doctors at Samy Medical, part of the same medical system as Purity Health, are available to manage your broader healthcare needs.

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