Hormone replacement therapy (HRT) is associated with a risk of breast cancer; thus, many woman avoid it at the time of menopause and endure the troublesome symptoms, which include hot flashes, vaginal diagnosis and mood disturbances. A new study has found that the risk of breast cancers varies widely among women based on ethnicity, body mass index (determines whether a person is overweight or underweight), and breast density. The study should help a women decide whether she should take HRT when menopause approaches. The results were published on September 3 in the Journal of the National Cancer Institute by researchers affiliated with the University of Chicago and Children’s Hospital of Philadelphia.
The researchers acknowledged that numerous studies have demonstrated a positive association between HRT and breast cancer risk, this association may vary by patient factors. Therefore, the researchers reviewed data from the Breast Cancer Surveillance Consortium, which is a longitudinal (over time) registry of mammography screening in the United States. They examined 1,642,824 screening mammograms with 9,300 breast cancer cases in postmenopausal women aged 45 years or older. The investigators subjected the data to statistical analysis based on the following factors: race/ethnicity, age, and body mass index.
The investigators found that HRT use was associated with greater than 20% increased risk in white, Asian, and Hispanic women but not black women. The highest breast cancer risk was found for women with low/normal body mass index and extremely dense breasts, compared with nonusers of HRT. In overweight/obese women with less-dense breasts, no excess risk was associated with HRT use.
The authors concluded that the impact of HRT use on breast cancer risk varies according to race/ethnicity, BMI, and breast density. This risk stratification could help in advising HRT use for the relief of menopausal symptoms.
Take home message:
All medication has both risks and benefits. This study should help women decide, after consultation with a healthcare professional, whether HRT is right for them. It should not be taken as a recommendation for slender women to pile on the pounds so that they can take HRT. Obesity is associated with many health problems. Poor lifestyle choices, such as smoking, also increase the risk of breast cancer. Currently, low-dose estrogen patches are available, which have a lower risk of cancer than hormonal preparations used in past decades.