HRT Risk?
Comments
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My friend's oncologist said they are now trying to get gyn doctors to prescribe HRT for only the first couple of years after menopause, then ease off. I have been telling my friends to consider getting off HRT - some of them have been on it for as mch as 20 years. One gal said she takes a specially compounded type of estrogen, not Premarin (and no Progestin). Does anyone know if this makes a difference? I would think estrogen is estrogen - ditch it....
Thanks - Minz
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My stance is that until HRT (in whatever form) is proven to have no link to breast cancer, I'd say don't take it. For me, even the potential benefits do not outweigh the cancer risk. There are so many alternative methods for addressing heart disease and the negative effects of menopause that HRT should almost never be necessary treatment for anyone.
But that's just my take. I blame HRT, at least partially, for my cancer.
~Marin
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Hi,
My mother actually took HRT until she was 80. Then her doctor took her off, saying that he felt there was a link to not only cardiovascular disease, but also to BC.
I took it for a couple of years; wish I hadn't.
Annie
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You know, it's sort of ironic. No, it's REALLY ironic: I've been in/past menopause for 5 yrs already and decided right away not to take HRT. I even had a doctor harrass me about that decision--he actually (literally) pleaded with me to just try it (TRY it, you'll LIKE it). Made me think of those old stories about shady characters in alleys, pushing drugs on new users. I said no and dropped that doc.
My sister, OTOH, has been on HRT for more than 5 yrs because she just can't deal with the hot flashes etc. I think hers is a specially concocted type, and she gets tested now and then to see if it's the right amount. It is STILL an estrogen/progestin combination, tho.
So which of us, do you suppose, developed BC???
Life just ain't fair.
otter
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[Hey, Annie, good to see you again. Are you packed yet? I'm soooo glad you're making the trip.]
I forgot to add this to my post: It turned out that my IDC, which I think was there for a long time, was 95% positive for ER (neg for PR). I wonder what would have happened if that thing had developed and was being fed HRT all this time?
otter again.
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The FDA is after some of those bioidentical compounded estrogens.
Apparently they've made claims about it's wonderfulness that aren't held up by fact.
I think for bc gals that it's best to stay away from ANY estrogens.
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A new twist to the debate:
The Feb. 25, 2008, edition of Archives of Internal Medicine/vol 168 (No.4) contains an article entitled: "Estrogen Plus Progestin and Breast Cancer Detection by Means of Mammography and Breast Biopsy."
This was a study of 16600 postmenopausal women over more than a 5 year period. It concluded: "Use of conjugated equine estrogens plus medroxyprogesterone acetate for approximately 5 years resulted in more than 1 in 10 and 1 in 25 women having otherwise avoidable mammogram abnormalities and breast biopsies, respectively, and compromised the diagnostic performance of both. This adverse effect on breast cancer detection should be incorporated into risk-benefit discussions with women considering even short-term combined hormone therapy."
Part of the study participants received the drug and part received the placebo. Noted is that the study was stopped when the WHI Data Safety and Monitoring Board determined that more risks than benefits were associated with the use of conjugated equine estrogens plus medroxyprogesterone acetate.
Another chink in the armor of HRT.
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An article was on my computer today--titled "Estrogen Helps Bring Breast Cancer Back" from Web MD. Even our fat produces estrogen.
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I just saw a story that the latest finding is women on HRT's are coming up with lung cancer. They say it isn't a huge amount but it's there. Don't Dr.s read these studies? Or is big pharma at the helm in their prescription decisions?
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Here's another wrench thrown into the mix...
I was just reading an article the other day that was talking about the fact that, prior to tamoxifen coming onto the scene, high dose estrogen was the hormonal treatment of choice to treat breast cancer. Go figure!!!
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I think this strategy of using estrogens is 'salvage' therapy, after a cancer has been shown to progress with tamoxifen. I think most authorities do NOT advocate estrogen for prevention for women who have never had breast cancer or ovarian cancer. Some breast cancers seem to switch from being 'starved' by tamoxifen to being 'starved' by estrogen.
I have read some papers said that even in the Halstead radical mastectomy era, ( pre-lumpectomy, pre-chemo, pre-rad era) that there were some surgeons who knew that some women with breast cancer did better when they had an oopherectomy. (Can't find a citation at the moment.) -
leaf,
That's true about knowledge of a link between "hormones" (estrogen) and BC even many decades ago. One of my family members had BC way back in the 1940's. She was pre-menopausal at the time. Her treatment was a "Halstead radical" mastectomy, plus irradiation of her ovaries to eliminate that source of estrogen. She did just fine, as far as the BC was concerned--there was no recurrence. (The SE's of her abrupt introduction into menopause, plus the loss of muscle with the Halstead radical, were apparently pretty brutal.) She eventually died of something completely unrelated to her BC, 20+ years later.
otter
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I'm glad I found this link. I've been very worried about a friend of mine. One the same day she was told her mammogram was showing changes and she would need to start having them every 6 months, her 80 year old physician prescribed HRT for menopausal symptoms. I doubt he is familiar with the latest studies. I've tried talking to her to no avail. She says it is a quality of life issue and she only takes a pill every other day or every third day. She also thinks she is immune to BC because of some spiritual experience she's had telling her her end will come some other way. I am trying to convince her to see a younger physician for a second opinion. Can I (legitimately) tell her there are different kinds of hormones on the market -- some safer than others -- and a younger doc might be able to steer her in the right direction? She is adamant that she does not want to give these up.
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My experience with HRT is a little different .. my doc begged me to quit.
When I was in my late 30's I had my uterus removed, ovaries were left in. I didn't take HRT until I was about 46 when my ovaries were removed due to an 8 cm tortion cyst on one of them. I started HRT then. About 9 months later I had a stereotactic biopsy of my left breast. I thought nothing of it. I had always had cysts. They left the little metal chips to mark the spot. My doc called and said everything was fine. End of story. I never questioned it or asked to see the report. I never thought of breast cancer. (As an aside, it was a very stressful time, just caught my ex with his secy, and going through a divorce.) I moved out of state. Two years later I had a new doctor who begged me to quit HRT, I said no. I didn't want to be 48, single and in menopause. Three years later, in yet another state, I realize I haven't had a mammo in 1 1/2 years and that's BAD. Whoops. Bad mammo, bad stereo biopsy ... cancer in the same breast as previous biopsy, but different area. First thing to go, HRT. Instant menopause at 51, along with lumpectomy and rads. That was exactly one year ago.
Is there any significance to this or not, I don't know. My first questionable biopsy was 9 months after starting HRT. So, my guess is, I still would have got cancer, maybe just not as soon.
My tumor was 100% er/pr +.
Best bet overall ... skip the HRT (in my opinion).
Bren
PS - I might add that I am now a total information junky and know everything about my cancer.
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I know I was daignosed with IDC after 4 years on Estrace. My annual mamograms were normal then suddely claicifications.....aggressive . I am convinced that the HRT played a big part as I am estrogen Positive but on other hand maybe i wouldnt have been so goood about my annual mammogrmas if not on hrt.Mrs b
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That's what my friend's mammograms are showing -- calcifications. I'm so frightened for her. I can't tell if i'm overreacting because of my own ER positive bc or if this is really dangerous. Her theory is HRT can't be that dangerous or they would have taken it off the market.
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You mean, like cigarettes?
otter
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good one, otter.
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Hello Brenda, my comrade in arms - We followed same path - BC found in area where prior bx had taken place, after a longer than usual absence of having mammograms, and being abruptly taken off HRT - the fountain of youth - thank God for Ativan and Xanax is all I can say.
It has been one year, and hallelujah, we are still here. What a road it has been.
Thank you my friend, for letting me fall apart a million times and not judging me.
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Hello Brenda, my comrade in arms - We followed same path - BC found in area where prior bx had taken place, after a longer than usual absence of having mammograms, and being abruptly taken off HRT - the fountain of youth - thank God for Ativan and Xanax is all I can say.
It has been one year, and hallelujah, we are still here. What a road it has been.
Thank you my friend, for letting me fall apart a million times and not judging me.
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Good news. My friend, who I have been so worried about, has decided to consult with another physician about her hormone use. This time it is someone I approve of and I have resolved to keep my mouth shut if he tells her hormones are safe for her considering her risk factors.
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I too am boggled by HRT. For a long time after my diagnosis, I thought HRT was the cause having taken it for 20 years after hysterectomy. Yet, my maternal cousin has been on HRT for more than 35 years (after hysterectomy) is now in her 70's and still fine (we took the same HRT in the same dosage).
Reading about the history of breast cancer opened my eyes to the fact that BC is a very old disease, dating back to the beginning of time - long before HRT was thought of by drug companies. Unfortunately for us, records were not kept back then thus we don't have any way of knowing which commonalities, if any, those women shared but we know for certain it wasn't HRT.
Another factor is our risk INCREASES age we age despite the fact that our estrogen levels decrease. Isn't that odd?
It appears to me that something (?) in our own bodies is the cause, but WHAT that something is remains a mystery. All women have estrogen to a certain age, yet thankfully all women do not get breast cancer. All women with breast cancer have not partaken in HRT. Furthermore, all women with breast cancer are not BRCA 1 and/or 2 carriers. ????? Okay, obviously, something that's yet to be discovered is involved.
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