HRT and Breast Cancer - More Dangerous Than We Suspected: Pass the Word...

HRT–hormone replacement therapy–used to be a common cure for the symptoms of menopause. Hot flashes, dry vagina, moodiness, sleeplessness… hey, since your natural estrogen and progesterone hormones have deserted you, let’s get you back to “normal” by replacing them with manmade versions; here’s a prescription for Prempro. HRT worked very, very well for many, many women. We were grateful.

And then, on December 14, 2006, The New York Times broke a stunning story, a story that literally echoed around the world. A just-published study showed that rates for the most common form of breast cancer dropped precipitously between August 2002 and December 2003: a drop of 15 percent in just 16 months. And that that drop could be tied to the fact that so many women stopped taking hormone replacement therapy (HRT) drugs rather suddenly, exactly during that time. Why? The massive Women’s Health Initiative study, released in July 2002, indicated HRT increased breast cancer risk. And we grudgingly gave up our Prempro and put up with the hot flashes and mood swings and sleeplessness. And, as it turned out, we eliminated a major risk factor for breast cancer.

Still, after that initial firestorm of publicity, the furor died down. Oh, sure; those of us who’ve already had breast cancer learned our lesson; I imagine most of us have decided to put up with the night sweats if it means reducing our risk of recurrence. But for the women out there still blithely assuming “it can’t happen to me,” HRT probably looks like a pretty good solution to what can, after all, be really, REALLY bothersome post-menopausal side effects. “Breast cancer? I’m in good health, there’s no history in my family, I don’t smoke and only drink wine… nah, not me. These hot flashes are making me crazy, and I’m so nasty to my kids I can’t stand myself. I’m going for the HRT.” While the number of postmenopausal women taking HRT has dropped by about half, there are still about 57 million prescriptions for HRT drugs filled each year in the U.S. So there are still lots and lots of women deciding to take a chance on breast cancer rather than continue to feel crummy.

Now, new findings from a National Cancer Institute-funded study by the Fred Hutchinson Cancer Research Center in Seattle, released Jan. 15, show that HRT use for just 3 years increases a woman’s risk of some forms of breast cancer by 400%–in other words, if you’ve taken HRT for 36 months, particularly an estrogen-progestin combination, you’re four times more likely to get breast cancer than women who don’t take HRT. And the kind of cancer you’re more likely to get–lobular, or lobular-ductal–is known as the “sneaky breast cancer.” It’s hard to pick up on mammograms. It doesn’t present itself as a lump you can feel. It’s usually invasive. And it’s often pretty far along before anyone notices it. You get lobular, ladies, you’ve drawn the short straw.