Hormone Therapy and Breast Cancer: 12 years after WHI
A recent article published in Lancet Oncology puts into perspective the use of estrogen in women postmenopausally and their risks of developing breast cancer and of all cause mortality. The WHI was the study that made so many women get off of hormone therapy in 2002 with a scare that “hormone therapy caused cancer of the breasts”. However, this conclusion is far from the truth.
During the initial WHI study (reported in 2002), 10,739 postmenopausal women in the U.S. were studied. The findings were that the combination of estrogen plus a synthetic progestin increased the risk of developing breast cancer, with 8-9 more cases per 10,000 women years. However, in that same study, women who had a hysterectomy and only took estrogen had 5 less breast cancers per 10,000 women years; thus proving no increased risk of breast cancer using estrogen therapy.
In this recent study of 2012, 7645 of women (who had hysterectomies; i.e. 78% of the original WHI women either continued to take estrogen or placebo. The researchers discovered that women who had continued the estrogen therapy had a 23% reduction in the incidence of invasive breast cancer compared to those who took a placebo during the 12 year follow-up. Moreover, of those women who developed breast cancer, the ones on estrogen therapy had a 63% reduction in death from the disease compared to those in the placebo group.
The only group that showed an increase in breast cancer was the group on combined therapy of estrogen and a synthetic progestin. However, using natural bioidentical progesterone has not been shown to increase breast cancer. Thus, if you still have a uterus, use only the latter type of progesterone and not the synthetics.
What does this mean for you? If you are in menopause then you should take estrogen therapy. You don’t have an increased risk of breast cancer and you have an increased chance of living longer. If you do develop a breast cancer, it was not because you took the estrogen but that you just got the breast cancer from a normal risk. Moreover, if you did get a breast cancer, you would have a better risk of survival if you had taken estrogen rather than not taking it. Plus, there are a plethora of other benefits from taking estrogen, particularly the bioidentical type, with the result that you’ll live with better quality of life and have less chance of developing degenerative diseases.
At the office of Robert L. True, MD, we specialize in bioidentical hormone therapy (BHT) specifically using hormone pellets. The risk of breast cancer is the same whether or not you take BHT, but the benefits are multiple. Women who take BHT, over time, have less heart disease, less bone loss, less Alzheimer’s over time. In addition, they enjoy a better quality of life with improved libido, vaginal health, more energy, better cognitive function, improved collagen in the skin, and multiple other benefits.
If you have been hesitating on doing hormone therapy, this study should reassure you that you should no longer fear taking your estrogen. If you would like further information, call our office and schedule a consultation to discuss your options so you too can benefit from bioidentical hormone pellet therapy.
 Anderson, et al. “Conjugated equine oestrogen and breast cancer incidence and mortality in postmenopausal women with hysterectomy: extended follow-up of the Women’s Health Initiative randomized placebo-controlled trial” The Lancet Oncology, Vol. 13, No. 5, p476–486, March 7, 2012