Estrogen and Breast Cancer - The Evolving Mystery

As many women begin the transition through menopause a lot of consideration goes into the idea of taking Hormone Replacements - whether it is just Estrogen (Estrogen Therapy or ET) or a combination of Estrogen and Progesterone (Hormone Therapy or HT). For the purpose of this article Hormone Replacement Therapy (HRT) will refer to both HT and ET.

Replacing your hormones with either natural or synthetic (laboratory made) forms of hormones may offer some benefit by helping to reduce many of the symptoms of early menopause - such as, hot flashes, insomnia, moodiness, and vaginal dryness. As well as more serious problems that may result from menopause like weakened bones, and osteoporosis.

But as with EVERY pharmaceutical product made to help relieve pain or discomfort there are risks, and hormone therapy is not without them. What's important is that your unique health history and risk factors are discussed with your doctor to best determine whether or not HT or ET is the best option for you.

Estrogens Impact on the Breast

What you have to recognize is that the scientific community is just beginning to realize the uniqueness of every woman's hormone profile. The effect of HRT on one of your female friends may be vastly different from the effect they have on you. This is why there is such a large amount of variation in what each woman experiences as they transition through menopause. This is also one of the greatest challenges that Doctor's and Scientist face in their effort to understand the affects HRT has on the female breast.

Probably the biggest concern women have about HRT is the increased risk of that dreaded disease - Breast Cancer! Breast cancer risk, like many diseases, increases with age for women, but it is not specifically affected by menopause. Unfortunately, recent studies have generated a lot of conflicting data between HRT and breast cancer risk.

But, before I go into the risk of developing breast cancers from HRT, it is important that you understand how Estrogen and Progesterone hormones affect your body, or more particularly, your breasts.

There are two primary thoughts on how cancer develops in the breast. One is that cancer tends to appear in fast growing tissue - Estrogen (and Progesterone) can cause breast tissue to grow at a faster rate - therefore this may be one way Estrogen is related to developing breast cancer. A second theory is that when estrogen is broken down in breast tissue the resultant compounds may bind to genetic material (DNA) and damage it. Damaged DNA is a common cause of cancers. For the moment - these are two primary theories on how HRT may increase the development of breast cancer.

Understand that the scientific community is hard at work trying to unravel the link between Estrogen and Breast Cancer -- or if there is even really a link -- but good science takes time. There are so many variables (like medical history and diet) in every study that it is impossible to blame ET or HT alone for breast cancer. Although the results of many clinical trials does show that HRT MAY increase the risk of developing breast cancer.

The Risk Factors

As a result of the various studies and clinical trials done, one thing is for sure, many more studies will need to be done before we unravel the mystery of HRT and breast cancer. In the mean time be aware of the fact that: 

Breast cancer risk is increased with the use of ET, and to a greater extent with HT, use beyond 5 years. And observational data suggest a slight potential increase for breast cancer with HRT use for less than five years.

By how much the risk is increased is not exactly clear at this point and will likely vary depending on each woman's unique genetic makeup, diet and exposure to various environmental factors. Obviously, the risk factor of taking HRT has a much greater impact if you are already at risk of developing breast cancer. If you fit into any of the categories below - then most physicians would probably agree that you should avoid HRT. 

• If you are a breast cancer survivor: The concern is that HRT may stimulate the growth of small or hidden tumors, it is nearly impossible to determine how many women harbor these hidden cells known as micrometastases.
• If you have a family history of breast cancer: It is not clear whether women with a family history are at increased risk of developing breast cancer when taking HRT and therefore the medical community is cautious about recommending it.
• If you have a history of: Uterine cancer, Liver disease, Blood clots, Undiagnosed vaginal bleeding or Heart disease.

One major consideration when contemplating HRT should be whether or not you are at a higher than average risk of developing breast cancer. Some other minor factors that may increase your cancer risk are weight gain and women who experience menopause later in life than average.

HRT - A Personal Decision

HRT is really a personal choice - there is no right or wrong answer. While some women may not want to accept the risks associated with HRT others may want to. Each woman must decide for herself, with input from her doctor, the best course of action. Both patient and doctor should be comfortable with the decision to take HRT or to pursue other treatments.

If you do decide to try HRT make sure you work closely with your doctor - prescribing the right dosage may sometimes turn into a bit of a guessing game. Keep your doctor informed as to how you are feeling and whether or not you think it is helping. The best thing you can do is actually keep a journal and track the symptoms that you're hoping HRT will help with. The lower the dosages and the shorter the duration is best if you are worried about increased breast cancer risk. But again your personal situation should be discussed in detail with your doctor, if you have another medical condition where the benefits HRT provide outweigh the increased breast cancer risk, then HRT should be considered.

If HRT is not for you - you are not without help. Thanks to all the ongoing research, new therapies and alternatives are being investigated every day and have proven successful for many women. But a word of warning - since this is a very new field, don't necessarily believe every thing you hear and read. There are a lot of companies trying to take advantage of this relatively new market. And since a lot of the herbal remedies are not regulated by the FDA some companies will package almost anything with no regard for scientific data to back up their claims. Look for resources that are impartial and companies that provide actual data to support what they are claiming.

Lastly, I personally am an advocate of a healthy diet and active lifestyle to beat menopausal symptoms and weight gain -- you should know that every clinical study I have read has shown that these two factors are proven to ease the menopause transition by regulating hormones naturally. And with no increased risk of breast cancer -- actually eating the right foods will help prevent breast cancer as well as many other types of cancer and disease. So regardless of your HRT decision -- the first step you should take when it comes to helping yourself is to eat a proper macronutrient profile and get that body of yours moving!