Hormone Replacement Therapy (HRT) and Breast Cancer

Through the years, doctors have prescribed hormone replacement therapy to millions of women, making this drug regimen one of the most frequently prescribed medical treatments in the U.S. Hormone replacement therapy describes a type of treatment in which women take estrogen, progesterone or a combination of both hormones to combat the negative physical effects of menopause. The low estrogen production typical in menopausal women can causes them to suffer from hot flashes, vaginal dryness, severe mood swings, arrhythmia and insomnia.

As a result, the use of HRT is still controversial and should be carefully considered according to each individual case. Hormone replacement therapies should only be prescribed to patients who are at an extremely low risk of developing any of the negative side effects of this treatment.

Hormone receptor breast cancer refers to a type of breast cancer that arises and grows due to the presence of estrogen and/or progesterone receptors on cancerous cells in the breast. Hormone receptors are highly refined proteins on a cell’s surface that are designed to interact and bind with certain, specific hormones.

 

In cases of hormone receptor positive (HR+) breast cancer, tumors grow because their HR+ cells are getting the estrogen and progesterone they need to reproduce. About 75 percent of all breast cancer cases are hormone receptor positive.

 

As a result, women who have hormone receptor positive cells shouldn’t be prescribed hormone replacement therapy to treat menopause symptoms, as these women are at a particularly higher risk of developing breast cancer. HRT will introduce more estrogen and/or progesterone into these women’s systems, feeding the HR+ cells and promoting the growth of cancerous cells in the breast.

 

Instead, menopausal women who have a history of breast cancer or who are starting to develop breast cancer will be prescribed a series of antiestrogen drugs, such as Tamoxifen®, the most prescribed drug in the treatment of HR+ and metastatic breast cancer.

Tamoxifen® is an antiestrogen drug that binds to hormone receptor positive cells to prevent them from interacting with estrogen. While Tamoxifen® has been proven effective in preventing breast cancer in HR+ patients, it has also been linked to the development of endometrial (uterine) cancer. Another downside to Tamoxifen® is the fact that it isn’t effective in all HR+ patients. Some who have taken Tamoxifen® still develop breast cancer.

 

An alternative to Tamoxifen® is Falsodex®. This drug, administered monthly through an injection, works much in the same way as Tamoxifen®. However, Falsodex® has the added benefit of also being able to alter the hormone receptors so that they are permanently unable to bind with estrogen and/or progesterone. Clinical trials have revealed that Falsodex® has been effective in menopausal women when Tamoxifen® failed.

 

If you are at a menopausal women with a high risk of developing breast cancer (namely, you have HR+ cells), be sure to discuss all of your treatment options with your doctor so that you can find the right regimen for you.

 

 

Barrett, Stephen (2003). Hormone Replacement Therapy (2003). Retrieved July 1, 2007 from: http://www.quackwatch.org/03HealthPromotion/hrt.html.

Breast Cancer Answers (2007). What is Hormone Receptor Positive Breast Cancer? (2007). Retrieved June 30, 2007 from: http://www.breastcancer-answers.com/webcast_transcript.asp?
f=breast_cancer&c=breast_hormrecept&b=breastcanceranswers.