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  • Q&A with Australian Health Practitioners

    Does HRT cause breast cancer?

    Related Topics
    Menopause Women's Health
    Most of the women I play bridge with who have taken HRT have developed breast cancer- I have heard there is a link, is this true?
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    Jean Hailes for Women's Health

    Jean Hailes for Women’s Health is a leader in women’s health, supported by funding from the Australian Government. We provide trusted and easy-to-understand information to … View Profile

    For otherwise healthy women, taking hormone replacement therapy (HRT) for two to five years to relieve menopausal symptoms causes little if any increase in breast cancer risk.If you're not taking HRT during menopause, you have a 3 in 1000 chance of developing breast cancer in a given year. If you take HRT for five years, that chance goes up slightly to just under 4 in 1000. Weigh this small risk against the benefits of HRT: It can significantly improve women's quality of life and reduce risks of osteoporosis, diabetes and colon cancer.

    If you want to take HRT, experts suggest taking the lowest effective dose of HRT, for only as long as required by your symptoms, and regularly review your reasons to continue (or not) with your health practitioner. HRT can be stopped at any time, after which any increase in breast cancer risk lessens over time and is lost within five years.

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    Dr Barry Wren

    Endocrinologist, Gynaecologist

    Dr Barry Wren was one of the original founders of the International Menopause Society in 1976 and subsequently founded the Australian Menopause Society, becoming its … View Profile

    Breast cancer is caused by the accumulation, over many years, of a series of mutations occurring in duct or glandular cells in the breast. Research now confirms that it requires about 200 different mutations within a cell to induce a malignant change. Some of these abnormal mutations are inherited from parents ( some women are born with a large number of these mutations), some are caused by toxins in the environment, some are caused by viruses and some occur spontaneously as stem cells are undergoing normal cell division. Estrogen does not cause a mutation but from the age of about 10 years estrogen promotes growth of all cells in the breast. It is true that as a woman passes through her adolescent years, estrogen from her ovaries increases the rate that cells divide and results in normal development and growth of a woman's breast  - the increase in cell division under the influence of normal ovarian estrogen explains  why women develop breast cancer 100 times more frequently than men. However, research from several major studies does demonstrate that post menopausal women using estradiol alone have a REDUCED risk of breast cancer so it is now thought that the mutational changes that ultimately end in a diagnosed breast cancer actually are initiated while a woman is pre-menopausal. If she doesn't have the necessary number of mutations before reaching her menopause, then HRT will not cause cancer - but it may make a cell that has accumulated these abnormal mutations to grow faster.

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