By Basant El-Faramawy
As more women turn to hormone therapy to relieve menopausal symptoms like hot flashes and night sweats, some physicians and scientists warn that the small increase in breast cancer risk associated with certain systemic treatments is not receiving enough attention.
Longstanding Debate Over Hormone Therapy
The link between breast cancer and hormone therapy has been debated for decades. In 2002, the Women’s Health Initiative study found that older women taking a combination hormone pill had higher breast cancer rates, causing prescriptions to plummet from 18.8 million in 2001 to 5.3 million in 2003. Estrogen-only treatment, used after hysterectomy, showed no such risk.
Pendulum Swings Back Toward Treatment
In recent years, federal health officials removed the drugs’ black box warning emphasizing risks, though they retained language linking combination therapy to breast cancer and cardiovascular disease. Major medical societies now strongly endorse these medications for menopausal symptoms, which affect nearly half of women aged 40 to 60. Doctors recommend starting therapy within 10 years of menopause and before age 60 to protect against heart disease risks.
Newer Formulations, Persistent Data Gaps
Newer hormone formulations are believed to carry less breast cancer risk than older drugs, but long-term safety data remain scarce. Garnet Anderson, a principal investigator of the Women’s Health Initiative at the Fred Hutch Cancer Center, said cancer must remain part of the risk-benefit conversation. “I think it’s being underplayed,” she said.
Concerns About Social Media Claims
Dr. Lisa Larkin, founder of Ms. Medicine, noted that hormone use has doubled over the past five years, yet fewer than 4 percent of women use hormones. She expressed concern that patients encounter claims about benefits on social media without hearing about risks.
