Have a Family History of Breast Cancer? Know Your HRT Options
Many women with a family history of breast cancer have concerns about using hormone replacement therapy (HRT) to manage menopause symptoms. Menopause Society Certified Practitioner Dr. Nina Ali addresses these common concerns and shares advice for talking with your doctor about whether HRT may be right for you.
Transcript:
Jamie Forward: This person says, “What’s the most recent research on HRT for menopausal women with a family history of breast cancer?” So, Dr. Ali, do you want to take that one?
Dr. Nina Ali: I think this is one of the most pervasive myths is that if I have a family history of breast cancer, I’m not a candidate for hormone therapy. And I think we have great sort of risk calculators on what breast cancer risk is for that individual, and family history is an important part of that. The hard part is, breast cancer is very prevalent, it’s been that 1 in 8 number for decades, and that pretty much hits most families and most friend groups. So, most of us will know a close person in our life that has been affected by breast cancer.
But having a family history is not a contraindication to you being able to take hormone therapy, but it does mean you may have a higher baseline risk than the next person who doesn’t have that family history. So, I think those kinds of conversations, again, are the things that need to be discussed and also weighed. So, every person’s going to have their threshold of risk that they’re comfortable with and risk that they’re not comfortable with. And if you decide, “Hey, I’ve heard about the numbers and what we know and I feel like I would benefit from hormone therapy even in the short term for a few years,” that might be a great choice.
The next person with the same history and the same numbers may look at those and say, “I really don’t want to worry about that, and I would prefer to use one of our great nonhormonal options that will also manage those symptoms really well.” So, again, it is nuanced for those reasons.
And then one thing that didn’t come up in our conversation is the genitourinary syndrome of menopause and the local hormone therapy that we use, whether it’s vaginal estrogen creams or tablets or ring or there are a few different options there too. But those are local and can be used for women who have contraindications to the systemic options like breast cancer personally or blood clots. So, I did want to just plug that in because that’s another common misconception.
