In a groundbreaking presentation at The Menopause Society 2023 Annual Meeting, Dr. Holly J. Pederson highlighted the remarkable benefits of hormone therapy (HT) for women, even those at high risk for breast cancer. Contrary to widespread concerns, the risks associated with exogenous hormones are low, particularly when weighed against the substantial benefits they offer.
For women carrying the BRCA1 and BRCA2 mutations, combined oral contraceptives have been linked to a 50% reduction in ovarian cancer risk and do not increase the risk of breast cancer, even before a full-term pregnancy. Additionally, early surgical menopause, often a concern for high-risk patients, can be effectively managed with hormone therapy. HT not only reduces hot flashes and prevents bone loss but has been associated with a 50-55% lower risk of breast cancer in BRCA2 carriers, with no increase in risk from hormone use.
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Furthermore, the impact of HT on cardiovascular health is crucial. Postmenopausal HT has been shown to reduce all-cause mortality by 30% when initiated in young menopausal women, underscoring its significant role in promoting heart health.
The key takeaway from this research is the importance of individualised therapy and recommendations. While considering a personal or family history of breast cancer, healthcare providers should also assess the history of early cardiovascular disease. Shared decision-making between patients and healthcare providers, backed by the latest data, is essential in optimising women's health in midlife.
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