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Hormone replacement therapy in patients with a prior history of breast cancer 

Hormone replacement therapy in patients with a prior history of breast cancer
Chapter:
Hormone replacement therapy in patients with a prior history of breast cancer
Author(s):

Gilbert G. Fareau

and Rena Vassilopoulou-Sellin

DOI:
10.1093/med/9780199218141.003.0008
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date: 05 June 2020

Women with a history of breast cancer are more likely to be exposed to oestrogen deficiency, and may experience oestrogen deficiency for longer durations than women in the general population.

For some women, the symptoms of oestrogen deficiency can be prolonged, extremely debilitating, and severely compromise quality of life.

Although hormone replacement therapy (HRT) remains the most effective agent for the treatment of climacteric symptoms, the evidence no longer favours its routine use in postmenopausal women. Alternative approaches to correct or palliate the sequelae of oestrogen deficiency should be explored.

In the absence of definitive safety data, we continue to counsel our patients that a history of breast cancer remains a relative contraindication to HRT; we parti-cularly discourage patients with recently treated, exten-sive, or hormonally responsive disease from using HRT.

If menopausal symptoms or skeletal morbidity com-promise a breast cancer survivor’s health or quality of life, oestrogen use may be considered following indi-vidualized discussion with the patient. In these cases, the lowest effective dose of oestrogen should be prescribed for the shortest tolerable duration.

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