If you are over 50 years of age, taking HRT for more than a year or two increases your risk of breast cancer. So, if you are over 50 years of age and have an increased risk of breast cancer because of your family history, it’s usually best to avoid HRT.
However, your doctor will take into account your individual circumstances when talking this over with you. Factors that can affect the balance between the risks and benefits of HRT include your age, how severe your menopausal symptoms are and your personal risk of osteoporosis (brittle bones). There are alternatives to HRT for managing menopausal symptoms, which your doctor can discuss with you.
If you have an early menopause, before you are 50 years of age, the benefits of HRT may outweigh the risks, even if you have a family history of breast cancer. This will depend on all the factors mentioned above, so it’s best to talk things over with your specialist.
When a woman with a family history of breast cancer takes HRT her doctor will usually prescribe as low a dose as possible for as short a time as possible.
HRT that contains only oestrogen increases the risk of breast cancer less than ‘combined HRT’, which also contains progesterone. So, oestrogen only HRT is preferred where possible. Oestrogen only HRT can affect the lining of the womb so is usually only prescribed for women who have had their womb removed.
Breast cancer is a common cancer. So, although you have a family history of breast cancer this may be due to chance rather than a faulty gene. If your GP thinks you may have an increased risk of breast cancer they can refer you to a cancer genetics clinic or a specialist breast clinic, where you would be given advice about your risk of breast cancer and the risks and benefits of HRT in your situation.
The National Institute for Clinical Excellence (NICE) is a government body that gives advice and information on treatments within the NHS in England and Wales. NICE have produced information for women with breast cancer in the family.
Reference
- McIntosh A et al. 2004. Clinical guidelines and evidence review for the classification and care of women at risk of familial breast cancer.