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a woman preforms a self breast exam
by
Dr. Sharon Malone
,
October 27, 2022

New Guidelines on MHT and Breast Cancer

The news about breast cancer and MHT is actually quite encouraging.

Your risk for developing breast cancer is your risk. Taking estrogen and progestin after menopause does not appear to increase that risk.

The number one reason why women avoid the use of Menopausal Hormone Treatment (MHT) is the fear of breast cancer. And yet, the news about breast cancer and MHT is actually quite encouraging. The North American Menopause Society (NAMS) has released new guidelines that should clear things up. But, let's start at the beginning. Why do women think taking estrogen increases their risk? Easy. It’s because we in the medical community have been telling them that for over twenty years, based on the flawed and misinterpreted conclusions from the landmark Women’s Health Initiative study.

Here’s the deal. Breast cancer is common. One in eight women will be diagnosed with breast cancer in her lifetime. But, here’s the thing: You have to live to be over 80 to get to that risk level, since your risk increases as you age. The bigger question is: Does taking MHT add to that risk? And the answer is, not really. Even with the estrogen and progestin formulation used in the WHI, the increased risk of breast cancer that we can possibly attribute to hormones is less than one additional case of breast cancer, per 1,000 women, per year. This risk is similar to the additional risk of drinking more than one glass of wine per day.

More importantly, for women diagnosed with breast cancer while on hormones, the risk of dying from breast cancer does not increase. New studies from the UK have shown no increase in breast cancer diagnosis for women who used estrogen and natural progesterone, and a study from Finland reported a reduction in deaths from breast cancer in women who took estrogen alone and who took estrogen and progestin.

How does all this relate to the new North American Menopausal Society’s guidelines about the use of hormone therapy?

In their new guidelines, NAMS has said that “a preponderance of data does NOT show an additive effect of underlying breast cancer risk (age, family history, genetic risk of breast cancer, benign breast disease, personal breast cancer risk factors) and hormone therapy use on breast cancer incidence.” In plain English, your risk for developing breast cancer is your risk. Taking estrogen and progestin after menopause does not appear to increase that risk. We can’t look into a crystal ball and see who will get breast cancer, but this we can safely say—even if you develop breast cancer while on hormone therapy your outcome, when diagnosed early, is certainly no worse and may actually be improved.

In the meantime, there are things you can do to decrease your breast cancer risk.

  1. Drink fewer than two glasses of wine or alcohol per day
  2. Exercise regularly
  3. Maintain a healthy weight
  4. Get screened regularly for breast cancer

The biggest reason for denying yourself the ability to feel good as you age just went away. The decision to take hormones or not to take hormones is a personal one, but thank goodness the list of reasons for NOT taking them just got way smaller. Our job at Alloy Women’s Health is to give you the latest scientific information that you need to make decisions about your health based on facts, not fear.

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Dr. Sharon Malone is among the nation’s leading obstetrician / gynecologists with a focus on the specific health challenges associated with menopause. She is also the Chief Medical Officer at Alloy.

Dr. Malone brings decades of clinical and real-life experiences to her treatment of women in the menopausal transition and the post-reproductive years.

Born in Mobile, Alabama, the youngest of 8 children, Dr Malone was raised by her siblings after the death of her mother and moved multiple times, changing schools four times in four years in three different states. Dr. Malone found strength and resilience in community, in her own work ethic and in her strong belief that there are no accidents in the universe. She went on to graduate cum laude from Harvard with a degree in Psychology and Social Relations and later graduated with honors from the Columbia University College of Physicians and Surgeons. Upon completing her residency at The George Washington University, Dr. Malone served women across Washington DC in her almost 30 years as a practicing Ob/Gyn. As Chief Medical Officer of Alloy, Dr Malone wants to bring her expertise to women on a larger scale. She believes that all women should be able to make decisions regarding their health and quality of life base on facts – not fear.

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