Question 27 - HRT In Conjuction With A History Of Breast Cancer
(Posted March 15, 2000)

Dr N

My wife has had a long history of uterine fibroids and now has one near her ovary that seems to be fast growing. She is 53 years of age, post menopausal and had a small lump removed from a breast 5 years ago with follow up radiation and chemotherapy. Her gynecologist recommends complete hysterectomy with removal of ovaries which is supported by second opinion. We are concerned about measuring the adverse effects of no HRT against the possibility HRT may cause cancer. How can we weigh these 2 risks and make a decision which way to go? She has her surgery in 4 days so thanks for a quick reply.

Hi,

These are difficult decisions for most patients to make. There is no research that I know of that suggests that there is any increase in cancer reoccurrence when HRT is given to women who have had early stage breast cancer.

Nevertheless, the fear that estrogen will result in an increased possibility of a reoccurrence prevents most women from using HRT following breast cancer. An additional problem is the reluctance of many physicians to prescribe HRT following breast cancer. This stems both from a lack of awareness that the literature does not suggest increased rates of reoccurrence when HRT is used following treatment of early stage breast cancer and/or a fear of a future malpractice action.

The potential problems with health and quality of life related to hormone deprivation are well appreciated. It is important that the 2 of you decide which avenue to pursue and that you not be interfered with by anyone with an agenda other than your best interests.

Let me know what and how you do.

Dr N