Breast cancer recurrence not caused by hormone replacement treatment: Study

Despite the fears of some academics and clinicians, a recent study at Oxford University found no relationship between menopausal hormone treatment and breast cancer recurrence.

The study’s findings were published in the journal “JNCI Journal of the National Cancer Institute.” Hot flashes and nocturnal sweats, as well as vaginal dryness and urinary tract infections, are common complaints among breast cancer survivors. These symptoms reduce patients’ quality of life and may cause them to abandon treatment.

Vaginal oestrogen treatment or menopausal hormone therapy may help to reduce these symptoms. The safety of systemic and vaginal oestrogen usage in breast cancer survivors, particularly those with oestrogen receptor-positive illness, has been questioned.

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Following the discovery of an elevated risk of breast cancer recurrence in two trials in the 1990s, many clinicians advise breast cancer survivors against utilising menopausal hormone treatment. Although later studies did not find an increase in recurrence, they had major drawbacks, such as small sample numbers and short follow-up periods.

In this study, researchers looked at the relationship between hormonal therapy and the risk of breast cancer recurrence and death in a large cohort of Danish postmenopausal women with early-stage oestrogen receptor-positive breast cancer. The study included longitudinal data from a nationwide cohort of postmenopausal women diagnosed with early-stage breast cancer between 1997 and 2004 who underwent no treatment or five years of hormone therapy, as determined by Denmark’s national prescription registry.

Previous diagnosis of breast cancer

Following a breast cancer diagnosis, 1957 and 133 women who had not previously undergone vaginal oestrogen treatment or menopausal hormone therapy used vaginal oestrogen therapy or menopausal hormone therapy, respectively. There was no increase in the risk of recurrence or death for individuals who got either vaginal oestrogen treatment or menopausal hormone therapy, according to the researchers.

“This large cohort study helps to inform the nuanced discussions between clinicians and breast cancer survivors about the safety of vaginal estrogen therapy,” said Elizabeth Cathcart-Rake, who wrote an editorial to accompany the article.

“These results suggest that breast cancer survivors on tamoxifen with severe genitourinary symptoms can take vaginal estrogen therapy without experiencing an increase in their risk for breast cancer recurrence. However, caution is still advised when considering vaginal estrogen for breast cancer survivors on aromatase inhibitors, or when considering menopausal hormonal therapy.”

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