As I am sure you are all too aware, the link between HRT and breast cancer has been in the media again this last week. It unfortunately feels all too reminiscent of the media coverage following the publication of the Women’s Health Initiative (WHI) and Million Women Study (MWS) over a decade ago – which led to a generation of women being denied the choice of taking HRT.
Over the last few days I’ve been reading all the responses from colleagues working in the field of menopause care and I agree with all of them that the media response to this publication is alarmist and irresponsible.
No one is denying there is an association between HRT and breast cancer. Women who take HRT (particularly continuous combined HRT) do have a small increased risk of developing breast cancer, but we already knew this. What is interesting is that although the risk of developing breast cancer is slightly increased, there is no increased risk of actually dying from the disease. Furthermore, there are other lifestyle factors that confer a much greater risk in terms of breast cancer, such as obesity, alcohol and lack of exercise.
We should also consider the additional benefits that HRT provides. The improvement in quality of life that HRT offers the women who take it is hugely significant. Add to that the additional protective benefits against heart disease, stroke and osteoporosis – diseases that are potentially more threatening to a woman’s health than a diagnosis of breast cancer.
So, what can we take from all of this? Well, my advice remains the same. Recommending HRT (or not) is an individualised process. Women should be counselled about all the risks and benefits that taking HRT will offer them, so they can make an informed choice about their own health.