The Cancer Journal, May/June 2022: Special edition on hormone therapy and breast cancer
Introduction from Guest Editor – Avrum Bluming, University of South California
‘Oestrogen reconsidered: exploring the evidence for oestrogens benefits and risks’
In this article, Dr Louise Newson highlights a recent edition of The Cancer Journal that focuses on the subject of menopause, hormone therapy and breast cancer, with particular reference to Avrum Bluming’s Introduction.
Far too many women and healthcare professionals talk only about risks of HRT without considering the benefits. Fear or rather perceived fear of breast cancer is the most common reason why women do not take HRT. It is also the most common reason for healthcare professionals to resist prescribing HRT to perimenopausal and menopausal women.
The May/June 2022 issue of The Cancer Journal contains articles discussing evidence that oestrogen actually reduces risk of breast cancer and reviews data on the role of oestrogen in both the prevention and treatment of breast cancer. The special edition also presents information on the benefits of taking HRT especially with respect to reducing risk of heart disease and all-cause mortality, as well as reducing risk of osteoporosis. And there is also an article about the safety of using vaginal oestrogen preparations in women who have had breast cancer in the past.
As breast cancer is considerably more common in women than men, it has been assumed for many decades that oestrogen is implicated in the development of female breast cancer. Removing the ovaries and blocking oestrogen by surgery and medication are very common treatments for breast cancer. However, a prophylactic oophorectomy to treat breast cancer has led to inconsistent results. Interestingly, follow-up of the WHI study has shown that there is a 23% reduction in risk of breast cancer after 20 years of follow-up in women who have taken oestrogen only HRT, and a 40% reduction in their risk of mortality from breast cancer.
It is also very interesting to note that women who have had a full-term pregnancy – during which the body is exposed to high levels of oestrogen – it reduces the risk of developing breast cancer by around 70%. Oestrogen has even been used successfully to treat breast cancer in the past.
As it is now 20 years since the WHI study was published, the time is certainly right for us to think more carefully about the benefits of HRT and to consider whether oestrogen really is as ‘dangerous’ as we have been led to believe. The articles in this journal will really help us to reflect and consider that in some detail.
Hopefully, the next 20 years will really represent a shift in women’s health, and mean individuals are no longer denied an evidence-based treatment (HRT) that is associated with so many benefits.