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Hormone Replacement Therapy (HRT) and Contraceptives

HRT and Contraceptives

Based on evidence from various studies, the Women’s Health Initiative (or www.whi.org) and the Million Women Study, there is a very clear connection between HRT and the risk of developing breast cancer. The Million Women Study found that current users of HRT at recruitment were more likely than never users to develop breast cancer (adjusted relative risk 1.66) (see Lancet 2003; 362: 419-27). The above mentioned studies indicate that the breast cancer risk increases the longer HRT is taken.

An IARC evaluation of cancer risk and HRT concluded that combined oestrogen–progestogen therapy is carcinogenic. This is based on the numerous studies consistently reporting an increased risk of breast cancer in women who currently use or have recently used combined oestrogen–progestogen therapy.

For women who do not have a history of breast cancer it is advisable to discuss the risks and benefits of taking HRT with your doctor in order to make an informed decision as to whether HRT is right for you. It is further recommended that you review your current treatments with your doctor on a regular basis to know if they are still your best option. If you opt for HRT, ask to take the lowest effective dose for the shortest amount of time needed to treat your symptoms.

HRT is generally not recommended if you have a history of breast cancer as HRT may increase your risk of a recurrence of breast cancer (see HABITS trial). Any decision to take HRT should, therefore, be discussed in detail with your physician.

Oral Contraceptives and Breast Cancer

An IARC evaluation of the cancer risk with oral contraceptive use concluded: "There is sufficient evidence in humans for the carcinogenicity of combined oral oestrogen–progestogen contraceptives. This evaluation was made on the basis of increased risks for cancer of the breast among current and recent users only."